Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $234.42 / $234.42	Facility		$162.18	$234.42	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $194.98	Professional		$162.18	$162.18	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Facility		$354.81	$354.81	$354.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $269.15 / $288.40	Professional		$112.20	$269.15	$288.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $234.42 / $354.81	Facility		$162.18	$234.42	$354.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $162.18 / $234.42	Professional		$151.36	$162.18	$234.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $213.80 / $218.78	Facility		$177.83	$213.80	$218.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $208.93 / $354.81	Facility		$162.18	$208.93	$354.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $257.04	Professional		$70.79	$79.43	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $190.55 / $199.53	Professional		$186.21	$190.55	$199.53