Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Facility		$102.80	$102.80	$102.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.75 / $100.38 / $120.94	Professional		$96.75	$100.38	$120.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $205.60 / $205.60	Facility		$102.80	$205.60	$205.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
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 $100.38 / $120.94 / $156.54	Facility		$100.38	$120.94	$156.54
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 $100.38 / $120.94 / $156.54	Facility		$100.38	$120.94	$156.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $151.18 / $151.18	Professional		$102.80	$151.18	$151.18
United Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $100.78 / $115.90	Professional		$100.78	$100.78	$115.90