Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.50 / $186.50 / $186.50	Facility		$186.50	$186.50	$186.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.38 / $121.98 / $186.50	Professional		$106.38	$121.98	$186.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $153.77 / $153.77 / $153.77	Facility		$153.77	$153.77	$153.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.44 / $130.69 / $153.77	Professional		$18.44	$130.69	$153.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $540.44 / $551.29 / $597.91	Professional		$540.44	$551.29	$597.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $21.28 / $111.70 / $413.34	Facility		$21.28	$111.70	$413.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $16.11 / $16.80 / $21.28	Professional		$16.11	$16.80	$21.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $349.25 / $419.49 / $425.45	Facility		$349.25	$419.49	$425.45
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $349.25 / $419.49 / $425.45	Professional		$349.25	$419.49	$425.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $15.06 / $106.38 / $896.44	Facility		$15.06	$106.38	$896.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.73 / $20.26 / $153.77	Professional		$17.73	$20.26	$153.77
United Facility/Professional Professional Modifier Low / Median / High Price $89.05 / $105.46 / $175.76	Professional		$89.05	$105.46	$175.76