Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Facility		$80.04	$80.04	$80.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $92.85	Professional		$80.04	$80.04	$92.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $160.08 / $883.50	Facility		$75.51	$160.08	$883.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $94.39	Professional		$80.04	$80.04	$94.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.66 / $194.84 / $1,787.76	Professional		$156.66	$194.84	$1,787.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $647.90	Facility		$80.04	$80.04	$647.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $88.04 / $104.05	Professional		$80.04	$88.04	$104.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $92.12 / $624.34	Facility		$75.51	$92.12	$624.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $104.85 / $780.43	Facility		$80.04	$104.85	$780.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $780.43 / $2,250,000.00	Professional		$80.04	$780.43	$2,250,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $76.04 / $80.04 / $80.04	Professional		$76.04	$80.04	$80.04
United Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $92.05	Professional		$80.04	$80.04	$92.05