Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $366.25 / $366.25 / $366.25	Facility		$366.25	$366.25	$366.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.04 / $209.04 / $366.25	Professional		$209.04	$209.04	$366.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $240.34 / $240.34 / $240.34	Facility		$240.34	$240.34	$240.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.42 / $204.29 / $240.34	Professional		$33.42	$204.29	$240.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,061.30 / $1,082.61 / $1,174.20	Professional		$1,061.30	$1,082.61	$1,174.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $209.04 / $364.50 / $451.52	Facility		$209.04	$364.50	$451.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $41.83 / $321.38	Professional		$33.00	$41.83	$321.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $410.16 / $758.62 / $835.49	Facility		$410.16	$758.62	$835.49
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $685.85 / $823.79 / $835.49	Professional		$685.85	$823.79	$835.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $132.78 / $306.92 / $484.74	Facility		$132.78	$306.92	$484.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.42 / $39.79 / $240.34	Professional		$33.42	$39.79	$240.34
United Facility/Professional Professional Modifier Low / Median / High Price $193.68 / $208.08 / $408.40	Professional		$193.68	$208.08	$408.40