Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Facility		$48.56	$48.56	$48.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.70 / $47.42 / $57.13	Professional		$45.70	$47.42	$57.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $97.12 / $97.12	Facility		$48.56	$97.12	$97.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Professional		$48.56	$48.56	$48.56
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 $47.42 / $59.39 / $147.22	Facility		$47.42	$59.39	$147.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $147.22 / $147.22 / $147.22	Professional		$147.22	$147.22	$147.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.22 / $147.22 / $79,999.20	Facility		$147.22	$147.22	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.42 / $101.95 / $294.44	Facility		$47.42	$101.95	$294.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $139.86 / $1,968.75	Professional		$48.56	$139.86	$1,968.75
United Facility/Professional Professional Modifier Low / Median / High Price $57.13 / $57.13 / $65.70	Professional		$57.13	$57.13	$65.70