Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $308.99 / $4,684.68 / $8,728.00	Facility		$308.99	$4,684.68	$8,728.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $842.00 / $842.00	Facility		$842.00	$842.00	$842.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $256.27 / $304.02 / $360.13	Professional		$256.27	$304.02	$360.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $191.58 / $252.96 / $411.90	Facility		$191.58	$252.96	$411.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $186.56 / $272.02 / $284.08	Facility		$186.56	$272.02	$284.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $191.58 / $262.45 / $362.98	Facility		$191.58	$262.45	$362.98
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00