Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.51 / $4,704.00 / $8,728.00	Facility		$179.51	$4,704.00	$8,728.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.10 / $92.10 / $92.10	Facility		$92.10	$92.10	$92.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.56 / $188.35 / $212.06	Professional		$156.56	$188.35	$212.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.05 / $156.57 / $246.73	Facility		$81.05	$156.57	$246.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.60 / $158.51 / $163.47	Facility		$117.60	$158.51	$163.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.06 / $162.00 / $246.73	Facility		$81.06	$162.00	$246.73
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