Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $643.79 / $643.79 / $643.79	Facility		$643.79	$643.79	$643.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $401.88 / $402.60 / $643.79	Professional		$401.88	$402.60	$643.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $356.59 / $356.59 / $356.59	Facility		$356.59	$356.59	$356.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $303.10 / $356.59	Professional		$58.89	$303.10	$356.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,499.03 / $1,865.57 / $2,064.06	Professional		$1,499.03	$1,865.57	$2,064.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.33 / $421.97 / $1,694.03	Facility		$72.33	$421.97	$1,694.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.11 / $72.33 / $85.29	Professional		$55.11	$72.33	$85.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $857.99 / $1,136.84 / $1,384.89	Facility		$857.99	$1,136.84	$1,384.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,136.84 / $1,384.89 / $1,384.89	Professional		$1,136.84	$1,384.89	$1,384.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.78 / $401.88 / $1,694.03	Facility		$70.78	$401.88	$1,694.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $76.86 / $356.59	Professional		$58.89	$76.86	$356.59
United Facility/Professional Professional Modifier Low / Median / High Price $367.90 / $367.90 / $688.05	Professional		$367.90	$367.90	$688.05