Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $158.49 / $251.19	Professional		$123.03	$158.49	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $147.91 / $173.78	Professional		$19.95	$147.91	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $630.96 / $707.95	Professional		$537.03	$630.96	$707.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $27.54 / $229.09	Facility		$18.62	$27.54	$229.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $213.80 / $223.87	Professional		$208.93	$213.80	$223.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $295.12 / $363.08	Facility		$223.87	$295.12	$363.08
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $363.08 / $363.08	Professional		$295.12	$363.08	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $169.82 / $2,691,534.80	Facility		$28.84	$169.82	$2,691,534.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $147.91 / $194.98	Professional		$23.99	$147.91	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $138.04 / $186.21	Facility		$18.62	$138.04	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $181.97	Professional		$112.20	$117.49	$181.97