Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.77 / $269.77 / $269.77	Facility		$269.77	$269.77	$269.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.58 / $274.14 / $325.26	Professional		$258.58	$274.14	$325.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.70 / $22.70 / $22.70	Professional		$22.70	$22.70	$22.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $183.10 / $183.10 / $183.10	Professional		$183.10	$183.10	$183.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $259.49 / $283.26 / $580.01	Facility		$259.49	$283.26	$580.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $291.11 / $304.51 / $79,999.20	Facility		$291.11	$304.51	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $259.49 / $284.56 / $580.01	Facility		$259.49	$284.56	$580.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.70 / $1,800,000.00 / $2,400,000.00	Professional		$22.70	$1,800,000.00	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $258.47 / $258.47 / $258.47	Professional		$258.47	$258.47	$258.47