Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.96 / $85.96 / $85.96	Facility		$85.96	$85.96	$85.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $83.94 / $101.13	Professional		$80.90	$83.94	$101.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.96 / $171.92 / $171.92	Facility		$85.96	$171.92	$171.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.96 / $85.96 / $85.96	Professional		$85.96	$85.96	$85.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $171.96 / $201.94	Professional		$139.72	$171.96	$201.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.94 / $96.77 / $200.98	Facility		$83.94	$96.77	$200.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.31 / $102.31 / $195.93	Professional		$102.31	$102.31	$195.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $119.90 / $144.02 / $146.06	Facility		$119.90	$144.02	$146.06
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.94 / $111.24 / $188.62	Facility		$83.94	$111.24	$188.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.96 / $126.40 / $136.51	Professional		$85.96	$126.40	$136.51
United Facility/Professional Professional Modifier Low / Median / High Price $136.47 / $136.47 / $163.76	Professional		$136.47	$136.47	$163.76