Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,987.51 / $1,987.51 / $1,987.51	Facility		$1,987.51	$1,987.51	$1,987.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,167.72 / $1,334.34 / $1,987.51	Professional		$1,167.72	$1,334.34	$1,987.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,639.62 / $1,639.62 / $1,639.62	Facility		$1,639.62	$1,639.62	$1,639.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.66 / $1,393.68 / $1,639.62	Professional		$188.66	$1,393.68	$1,639.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,759.21 / $5,874.92 / $6,372.00	Professional		$5,759.21	$5,874.92	$6,372.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $233.61 / $1,226.10 / $2,334.54	Facility		$233.61	$1,226.10	$2,334.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $176.81 / $1,719.66 / $1,843.24	Professional		$176.81	$1,719.66	$1,843.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,721.85 / $4,470.42 / $4,533.89	Facility		$3,721.85	$4,470.42	$4,533.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,721.85 / $4,470.42 / $4,533.89	Professional		$3,721.85	$4,470.42	$4,533.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $233.61 / $1,226.10 / $4,398.17	Facility		$233.61	$1,226.10	$4,398.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $188.66 / $222.35 / $1,639.62	Professional		$188.66	$222.35	$1,639.62
United Facility/Professional Professional Modifier Low / Median / High Price $1,022.09 / $1,123.40 / $1,872.33	Professional		$1,022.09	$1,123.40	$1,872.33