Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $311.33 / $311.33 / $311.33	Facility		$311.33	$311.33	$311.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.90 / $135.69 / $173.83	Professional		$91.90	$135.69	$173.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $383.11 / $724.89 / $872.09	Professional		$383.11	$724.89	$872.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $173.83 / $182.52 / $647.90	Facility		$173.83	$182.52	$647.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $295.89 / $360.46 / $79,999.20	Facility		$295.89	$360.46	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $173.83 / $266.50 / $426.40	Facility		$173.83	$266.50	$426.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $266.50 / $266.50	Professional		$147.91	$266.50	$266.50
United Facility/Professional Professional Modifier Low / Median / High Price $342.87 / $342.87 / $394.30	Professional		$342.87	$342.87	$394.30