Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.88 / $355.88 / $412.82	Professional		$355.88	$355.88	$412.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $816.00 / $816.00	Facility		$408.00	$816.00	$816.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Professional		$408.00	$408.00	$408.00
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 $355.88 / $355.88 / $554.99	Facility		$355.88	$355.88	$554.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $355.88 / $355.88 / $79,999.20	Facility		$355.88	$355.88	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $355.88 / $373.67 / $765.14	Facility		$355.88	$373.67	$765.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $408.00 / $600.00 / $600.00	Professional		$408.00	$600.00	$600.00
United Facility/Professional Professional Modifier Low / Median / High Price $480.00 / $480.00 / $552.00	Professional		$480.00	$480.00	$552.00