Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $617.37 / $617.37 / $617.37	Facility		$617.37	$617.37	$617.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $433.34 / $444.96 / $617.37	Professional		$433.34	$444.96	$617.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $59.64 / $577.92	Professional		$59.64	$59.64	$577.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,437.48 / $1,788.97 / $1,979.29	Professional		$1,437.48	$1,788.97	$1,979.29
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.69 / $467.21 / $2,035.99	Facility		$72.69	$467.21	$2,035.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.39 / $72.69 / $111.64	Professional		$55.39	$72.69	$111.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,123.00 / $1,278.77 / $1,408.34	Facility		$1,123.00	$1,278.77	$1,408.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,156.09 / $1,388.62 / $1,408.34	Professional		$1,156.09	$1,388.62	$1,408.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.69 / $449.37 / $2,035.99	Facility		$72.69	$449.37	$2,035.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $85.05 / $108.63	Professional		$59.64	$85.05	$108.63
United Facility/Professional Professional Modifier Low / Median / High Price $438.49 / $438.49 / $730.81	Professional		$438.49	$438.49	$730.81