Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.48 / $80.48 / $80.48	Facility		$80.48	$80.48	$80.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $98.99	Professional		$87.98	$87.98	$98.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $134.63 / $189.86	Facility		$83.00	$134.63	$189.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $103.75	Professional		$87.98	$87.98	$103.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $157.91 / $196.42 / $272.32	Professional		$157.91	$196.42	$272.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $80.48 / $87.98 / $188.28	Facility		$80.48	$87.98	$188.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $93.26 / $114.37	Professional		$87.98	$93.26	$114.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $80.48 / $91.30 / $240.54	Facility		$80.48	$91.30	$240.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $96.78 / $189.16	Facility		$87.98	$96.78	$189.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $154.77 / $2,250,000.00	Professional		$87.98	$154.77	$2,250,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.58 / $87.98 / $87.98	Professional		$83.58	$87.98	$87.98
United Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $105.58	Professional		$87.98	$87.98	$105.58