Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.60 / $119.78 / $504.00	Facility		$109.60	$119.78	$504.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $80.00 / $322.00	Facility		$75.00	$80.00	$322.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $22.00 / $121.00 / $302.17	Facility		$22.00	$121.00	$302.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $150.75 / $215.00	Facility		$35.00	$150.75	$215.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $119.78 / $178.00 / $504.00	Facility		$119.78	$178.00	$504.00