Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $219.99 / $219.99 / $219.99	Facility		$219.99	$219.99	$219.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.86 / $124.86 / $219.99	Professional		$124.86	$124.86	$219.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.27 / $174.27 / $174.27	Facility		$174.27	$174.27	$174.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.86 / $148.13 / $174.27	Professional		$19.86	$148.13	$174.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $637.46 / $650.26 / $705.27	Professional		$637.46	$650.26	$705.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.38 / $142.00 / $283.26	Facility		$28.38	$142.00	$283.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $167.72 / $217.89	Professional		$22.39	$167.72	$217.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $224.98 / $296.45 / $361.13	Facility		$224.98	$296.45	$361.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $296.45 / $361.13 / $361.13	Professional		$296.45	$361.13	$361.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.38 / $142.00 / $407.53	Facility		$28.38	$142.00	$407.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.75 / $23.89 / $174.27	Professional		$19.75	$23.89	$174.27
United Facility/Professional Professional Modifier Low / Median / High Price $113.14 / $116.71 / $191.78	Professional		$113.14	$116.71	$191.78