Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.23 / $79.23 / $79.23	Facility		$79.23	$79.23	$79.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $88.26	Professional		$76.09	$76.09	$88.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.78 / $120.33 / $172.70	Facility		$71.78	$120.33	$172.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $89.73	Professional		$76.09	$76.09	$89.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $155.38 / $189.16 / $243.61	Professional		$155.38	$189.16	$243.61
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $76.09 / $79.23 / $369.05	Facility		$76.09	$79.23	$369.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $80.66 / $98.92	Professional		$76.09	$80.66	$98.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $76.09 / $83.70 / $169.84	Facility		$76.09	$83.70	$169.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $76.09 / $92.03 / $369.05	Facility		$76.09	$92.03	$369.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $115.55 / $2,250,000.00	Professional		$76.09	$115.55	$2,250,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.29 / $76.09 / $76.09	Professional		$72.29	$76.09	$76.09
United Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $87.50	Professional		$76.09	$76.09	$87.50