Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $427.34 / $427.34 / $427.34	Facility		$427.34	$427.34	$427.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $249.72 / $249.72 / $427.34	Professional		$249.72	$249.72	$427.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $238.50 / $238.50 / $238.50	Facility		$238.50	$238.50	$238.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.73 / $238.50 / $238.50	Professional		$202.73	$238.50	$238.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.23 / $1,263.20 / $1,370.06	Professional		$41.23	$1,263.20	$1,370.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $60.95 / $249.72 / $877.31	Facility		$60.95	$249.72	$877.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.84 / $45.81 / $48.10	Professional		$35.84	$45.81	$48.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $432.85 / $515.36 / $527.29	Facility		$432.85	$515.36	$527.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $432.85 / $527.29 / $527.29	Professional		$432.85	$527.29	$527.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.65 / $238.50 / $2,565.94	Facility		$36.65	$238.50	$2,565.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $47.76 / $238.50	Professional		$41.16	$47.76	$238.50
United Facility/Professional Facility Modifier Low / Median / High Price $35.84 / $202.00 / $269.45	Facility		$35.84	$202.00	$269.45
United Facility/Professional Professional Modifier Low / Median / High Price $170.42 / $170.42 / $280.02	Professional		$170.42	$170.42	$280.02