Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $82.41 / $82.41	Facility		$82.41	$82.41	$82.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $101.36	Professional		$89.75	$89.75	$101.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $103.89 / $143.63	Facility		$84.67	$103.89	$143.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $105.83	Professional		$89.75	$89.75	$105.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $161.65 / $193.20 / $212.60	Professional		$161.65	$193.20	$212.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $89.75 / $1,834.80	Facility		$82.41	$89.75	$1,834.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $95.13 / $112.19	Professional		$89.75	$95.13	$112.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $76.47 / $89.75 / $186.27	Facility		$76.47	$89.75	$186.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $84.59 / $89.75 / $1,834.80	Facility		$84.59	$89.75	$1,834.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $84.59 / $91.78 / $2,250,000.00	Professional		$84.59	$91.78	$2,250,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $85.26 / $89.75 / $89.75	Professional		$85.26	$89.75	$89.75
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $103.21	Professional		$89.75	$89.75	$103.21