Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $373.01 / $373.01 / $373.01	Facility		$373.01	$373.01	$373.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.90 / $352.14 / $373.01	Professional		$342.90	$352.14	$373.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Facility		$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.43 / $127.50 / $150.00	Professional		$54.43	$127.50	$150.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $868.50 / $1,080.85 / $1,195.86	Professional		$868.50	$1,080.85	$1,195.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.27 / $360.05 / $1,283.18	Facility		$67.27	$360.05	$1,283.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.25 / $59.83 / $67.27	Professional		$51.25	$59.83	$67.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $601.85 / $772.62 / $850.90	Facility		$601.85	$772.62	$850.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $698.50 / $838.99 / $850.90	Professional		$698.50	$838.99	$850.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.19 / $342.90 / $1,283.18	Facility		$60.19	$342.90	$1,283.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.43 / $65.59 / $150.00	Professional		$54.43	$65.59	$150.00
United Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $275.00 / $526.60	Professional		$275.00	$275.00	$526.60