Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.61 / $4,684.68 / $44,619.71	Facility		$149.61	$4,684.68	$44,619.71
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 $123.75 / $146.68 / $173.90	Professional		$123.75	$146.68	$173.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $94.07 / $122.14 / $202.25	Facility		$94.07	$122.14	$202.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.52 / $132.00 / $139.36	Facility		$91.52	$132.00	$139.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $94.07 / $128.34 / $179.34	Facility		$94.07	$128.34	$179.34
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $26.34 / $26.34 / $26.34	Facility	80	$26.34	$26.34	$26.34
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $22.39 / $22.39 / $22.39	Facility	AS	$22.39	$22.39	$22.39
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