Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.26 / $151.26 / $151.26	Facility		$151.26	$151.26	$151.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.92 / $91.92 / $164.25	Professional		$91.92	$91.92	$164.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.12 / $129.12 / $129.12	Facility		$129.12	$129.12	$129.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.75 / $129.12 / $129.12	Professional		$109.75	$129.12	$129.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $438.30 / $447.10 / $484.93	Professional		$438.30	$447.10	$484.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $24.34 / $125.93 / $282.32	Facility		$24.34	$125.93	$282.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $16.67 / $144.09 / $192.12	Professional		$16.67	$144.09	$192.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $238.89 / $267.30 / $325.62	Facility		$238.89	$267.30	$325.62
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $267.30 / $325.62 / $325.62	Professional		$267.30	$325.62	$325.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $24.34 / $129.12 / $350.26	Facility		$24.34	$129.12	$350.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.16 / $17.57 / $129.12	Professional		$15.16	$17.57	$129.12
United Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $108.16 / $160.66	Professional		$80.33	$108.16	$160.66