Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.98 / $182.98 / $182.98	Facility		$182.98	$182.98	$182.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.18 / $114.18 / $182.98	Professional		$114.18	$114.18	$182.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.98 / $123.98 / $123.98	Facility		$123.98	$123.98	$123.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.16 / $105.38 / $123.98	Professional		$17.16	$105.38	$123.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $530.23 / $540.88 / $586.64	Professional		$530.23	$540.88	$586.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $29.29 / $156.43 / $339.89	Facility		$29.29	$156.43	$339.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $21.02 / $29.29 / $231.30	Professional		$21.02	$29.29	$231.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $287.60 / $322.85 / $393.29	Facility		$287.60	$322.85	$393.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $322.85 / $393.29 / $393.29	Professional		$322.85	$393.29	$393.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $29.29 / $156.43 / $421.64	Facility		$29.29	$156.43	$421.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.13 / $21.83 / $123.98	Professional		$17.13	$21.83	$123.98
United Facility/Professional Professional Modifier Low / Median / High Price $97.01 / $97.01 / $194.02	Professional		$97.01	$97.01	$194.02