Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,963.72 / $1,963.72 / $1,963.72	Facility		$1,963.72	$1,963.72	$1,963.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,187.83 / $1,217.94 / $1,963.72	Professional		$1,187.83	$1,217.94	$1,963.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.19 / $144.19 / $144.19	Facility		$144.19	$144.19	$144.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.56 / $144.19 / $190.23	Professional		$122.56	$144.19	$190.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,572.28 / $5,690.28 / $6,295.74	Professional		$4,572.28	$5,690.28	$6,295.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $201.72 / $1,217.94 / $3,661.13	Facility		$201.72	$1,217.94	$3,661.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $157.61 / $191.69 / $242.92	Professional		$157.61	$191.69	$242.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,121.35 / $3,677.30 / $4,416.91	Facility		$2,121.35	$3,677.30	$4,416.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,121.35 / $2,584.19 / $2,584.19	Professional		$2,121.35	$2,584.19	$2,584.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $144.19 / $808.16 / $3,661.13	Facility		$144.19	$808.16	$3,661.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $144.19 / $213.80 / $237.23	Professional		$144.19	$213.80	$237.23
United Facility/Professional Professional Modifier Low / Median / High Price $835.19 / $835.19 / $1,391.98	Professional		$835.19	$835.19	$1,391.98