Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Facility		$85.00	$85.00	$85.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $83.00 / $100.00	Professional		$80.00	$83.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $170.00 / $170.00	Facility		$85.00	$170.00	$170.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $175.00 / $194.25	Professional		$150.00	$175.00	$194.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $100.00 / $129.44	Facility		$83.00	$100.00	$129.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $100.00 / $178.45	Facility		$83.00	$100.00	$178.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $125.00 / $2,400,000.00	Professional		$85.00	$125.00	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $160.91 / $185.06	Professional		$160.91	$160.91	$185.06