Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $66.07	Facility		$54.95	$54.95	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $81.28	Professional		$51.29	$63.10	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $144.54 / $162.18	Professional		$123.03	$144.54	$162.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $95.50 / $154.88	Facility		$66.07	$95.50	$154.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $89.13	Professional		$45.71	$67.61	$89.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $117.49 / $120.23	Facility		$97.72	$117.49	$120.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $83.18 / $125.89	Facility		$66.07	$83.18	$125.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $141.25	Professional		$51.29	$51.29	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $12.59 / $14.79	Professional		$5.01	$12.59	$14.79