Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $162.18 / $302.00	Facility		$158.49	$162.18	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $199.53	Professional		$162.18	$162.18	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $257.04 / $398.11	Facility		$154.88	$257.04	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $354.81 / $416.87	Professional		$162.18	$354.81	$416.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $173.78 / $204.17	Facility		$162.18	$173.78	$204.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $162.18 / $204.17	Professional		$144.54	$162.18	$204.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $162.18 / $309.03	Facility		$144.54	$162.18	$309.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $239.88 / $446.68	Facility		$162.18	$239.88	$446.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $177.83 / $213.80	Professional		$79.43	$177.83	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $194.98 / $218.78	Professional		$186.21	$194.98	$218.78