Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $291.64 / $291.64 / $291.64	Facility		$291.64	$291.64	$291.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.14 / $195.78 / $291.64	Professional		$193.14	$195.78	$291.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $240.50 / $240.50 / $240.50	Facility		$240.50	$240.50	$240.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $204.43 / $240.50	Professional		$26.88	$204.43	$240.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $845.11 / $862.09 / $935.03	Professional		$845.11	$862.09	$935.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $39.13 / $194.03 / $493.87	Facility		$39.13	$194.03	$493.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $29.42 / $30.89 / $39.15	Professional		$29.42	$30.89	$39.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $546.15 / $656.00 / $665.31	Facility		$546.15	$656.00	$665.31
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $546.15 / $656.00 / $665.31	Professional		$546.15	$656.00	$665.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $20.01 / $107.19 / $493.87	Facility		$20.01	$107.19	$493.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.54 / $37.27 / $240.50	Professional		$31.54	$37.27	$240.50
United Facility/Professional Professional Modifier Low / Median / High Price $139.06 / $164.78 / $274.64	Professional		$139.06	$164.78	$274.64