Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.06 / $380.06 / $380.06	Facility		$380.06	$380.06	$380.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.12 / $255.12 / $380.06	Professional		$255.12	$255.12	$380.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.77 / $172.77 / $172.77	Facility		$172.77	$172.77	$172.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.07 / $146.85 / $172.77	Professional		$36.07	$146.85	$172.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,101.30 / $1,123.43 / $1,218.46	Professional		$1,101.30	$1,123.43	$1,218.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $51.04 / $267.88 / $509.87	Facility		$51.04	$267.88	$509.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.63 / $301.92 / $392.21	Professional		$38.63	$301.92	$392.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $431.43 / $787.22 / $866.98	Facility		$431.43	$787.22	$866.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $711.70 / $854.84 / $866.98	Professional		$711.70	$854.84	$866.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $51.04 / $267.88 / $840.79	Facility		$51.04	$267.88	$840.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.07 / $48.58 / $172.77	Professional		$36.07	$48.58	$172.77
United Facility/Professional Professional Modifier Low / Median / High Price $181.32 / $214.81 / $358.01	Professional		$181.32	$214.81	$358.01