Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $388.38 / $3,213.00 / $8,728.00	Facility		$388.38	$3,213.00	$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 $322.32 / $382.14 / $452.94	Professional		$322.32	$382.14	$452.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $246.78 / $338.09 / $443.70	Facility		$246.78	$338.09	$443.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $262.60 / $343.91 / $367.83	Facility		$262.60	$343.91	$367.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $246.78 / $345.49 / $466.81	Facility		$246.78	$345.49	$466.81
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $59.30 / $59.30 / $59.30	Facility	AS	$59.30	$59.30	$59.30
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00