Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $584.17 / $584.17 / $584.17	Facility		$584.17	$584.17	$584.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $332.88 / $349.74 / $584.17	Professional		$332.88	$349.74	$584.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $429.00 / $429.00 / $429.00	Facility		$429.00	$429.00	$429.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.03 / $364.65 / $429.00	Professional		$54.03	$364.65	$429.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,360.20 / $1,692.79 / $1,872.89	Professional		$1,360.20	$1,692.79	$1,872.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $64.33 / $349.52 / $1,294.80	Facility		$64.33	$349.52	$1,294.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $49.01 / $60.36 / $64.33	Professional		$49.01	$60.36	$64.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $607.24 / $691.35 / $842.19	Facility		$607.24	$691.35	$842.19
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $691.35 / $842.19 / $842.19	Professional		$691.35	$842.19	$842.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.43 / $332.88 / $1,294.80	Facility		$58.43	$332.88	$1,294.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.03 / $63.68 / $429.00	Professional		$54.03	$63.68	$429.00
United Facility/Professional Professional Modifier Low / Median / High Price $272.19 / $272.19 / $453.65	Professional		$272.19	$272.19	$453.65