Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,121.08 / $1,121.08 / $1,121.08	Facility		$1,121.08	$1,121.08	$1,121.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $729.97 / $762.78 / $1,121.08	Professional		$729.97	$762.78	$1,121.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $881.10 / $881.10 / $881.10	Facility		$881.10	$881.10	$881.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.87 / $748.94 / $881.10	Professional		$109.87	$748.94	$881.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,610.30 / $3,248.56 / $3,594.20	Professional		$2,610.30	$3,248.56	$3,594.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $139.79 / $800.92 / $3,242.81	Facility		$139.79	$800.92	$3,242.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $101.88 / $139.79 / $156.03	Professional		$101.88	$139.79	$156.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,099.35 / $2,521.59 / $2,557.39	Facility		$2,099.35	$2,521.59	$2,557.39
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,099.35 / $2,521.59 / $2,557.39	Professional		$2,099.35	$2,521.59	$2,557.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $133.87 / $762.78 / $3,242.81	Facility		$133.87	$762.78	$3,242.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.87 / $145.88 / $881.10	Professional		$109.87	$145.88	$881.10
United Facility/Professional Professional Modifier Low / Median / High Price $702.64 / $826.52 / $1,293.47	Professional		$702.64	$826.52	$1,293.47