Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.73 / $105.73 / $105.73	Facility		$105.73	$105.73	$105.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.64 / $71.89 / $105.73	Professional		$68.64	$71.89	$105.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $98.98 / $177.75	Professional		$10.52	$98.98	$177.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $246.19 / $306.38 / $339.00	Professional		$246.19	$306.38	$339.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $12.44 / $72.06 / $307.93	Facility		$12.44	$72.06	$307.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $9.47 / $12.44 / $14.37	Professional		$9.47	$12.44	$14.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $144.60 / $219.01 / $241.20	Facility		$144.60	$219.01	$241.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $198.00 / $237.82 / $241.20	Professional		$198.00	$237.82	$241.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $12.44 / $70.79 / $307.93	Facility		$12.44	$70.79	$307.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $10.13 / $13.13 / $98.98	Professional		$10.13	$13.13	$98.98
United Facility/Professional Professional Modifier Low / Median / High Price $50.45 / $50.45 / $100.91	Professional		$50.45	$50.45	$100.91