Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.56 / $126.00 / $168.00	Facility		$104.56	$126.00	$168.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $63.93 / $162.00	Professional		$38.00	$63.93	$162.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $65.00 / $87.85	Professional		$51.00	$65.00	$87.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.00 / $72.83 / $84.00	Professional		$62.00	$72.83	$84.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $4,346.00 / $4,845.79 / $5,085.88	Facility		$4,346.00	$4,845.79	$5,085.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $13,910.16 / $17,150.38 / $18,772.80	Professional		$13,910.16	$17,150.38	$18,772.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $104.00 / $138.00	Facility		$78.00	$104.00	$138.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.40 / $3,232.79 / $5,085.88	Facility		$81.40	$3,232.79	$5,085.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $65.00 / $83.75	Professional		$57.00	$65.00	$83.75
United Facility/Professional Professional Modifier Low / Median / High Price $47.15 / $47.15 / $47.15	Professional		$47.15	$47.15	$47.15