Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Facility		$102.85	$102.85	$102.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.80 / $100.43 / $121.00	Professional		$96.80	$100.43	$121.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $205.70 / $205.70	Facility		$102.85	$205.70	$205.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Professional		$102.85	$102.85	$102.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $175.00 / $194.25	Professional		$150.00	$175.00	$194.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.43 / $110.47 / $156.62	Facility		$100.43	$110.47	$156.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.43 / $121.00 / $156.62	Facility		$100.43	$121.00	$156.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $137.50 / $137.50	Professional		$102.85	$137.50	$137.50
United Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $110.00 / $126.50	Professional		$110.00	$110.00	$126.50