Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.75 / $389.75 / $389.75	Facility		$389.75	$389.75	$389.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.36 / $222.36 / $389.75	Professional		$222.36	$222.36	$389.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.78 / $219.78 / $219.78	Facility		$219.78	$219.78	$219.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $186.81 / $219.78	Professional		$35.88	$186.81	$219.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,129.38 / $1,152.07 / $1,249.55	Professional		$1,129.38	$1,152.07	$1,249.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $44.49 / $258.68 / $516.01	Facility		$44.49	$258.68	$516.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.11 / $44.49 / $342.12	Professional		$35.11	$44.49	$342.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $436.63 / $807.29 / $889.09	Facility		$436.63	$807.29	$889.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $729.85 / $876.64 / $889.09	Professional		$729.85	$876.64	$889.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $44.49 / $258.68 / $639.92	Facility		$44.49	$258.68	$639.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $42.34 / $186.81	Professional		$35.88	$42.34	$186.81
United Facility/Professional Professional Modifier Low / Median / High Price $158.03 / $220.00 / $361.50	Professional		$158.03	$220.00	$361.50