Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $429.40 / $429.40 / $429.40	Facility		$429.40	$429.40	$429.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.68 / $385.68 / $429.40	Professional		$385.68	$385.68	$429.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $370.80 / $370.80 / $370.80	Facility		$370.80	$370.80	$370.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.24 / $315.18 / $370.80	Professional		$57.24	$315.18	$370.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $999.81 / $1,244.28 / $1,376.68	Professional		$999.81	$1,244.28	$1,376.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.27 / $404.96 / $1,456.65	Facility		$70.27	$404.96	$1,456.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.54 / $70.27 / $79.86	Professional		$53.54	$70.27	$79.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $803.39 / $889.42 / $979.54	Facility		$803.39	$889.42	$979.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $804.10 / $965.83 / $979.54	Professional		$804.10	$965.83	$979.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.85 / $385.68 / $1,456.65	Facility		$60.85	$385.68	$1,456.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.24 / $73.76 / $370.80	Professional		$57.24	$73.76	$370.80
United Facility/Professional Professional Modifier Low / Median / High Price $316.58 / $316.58 / $527.63	Professional		$316.58	$316.58	$527.63