Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,229.16 / $1,229.16 / $1,229.16	Facility		$1,229.16	$1,229.16	$1,229.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $701.28 / $701.28 / $1,229.16	Professional		$701.28	$701.28	$1,229.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $606.51 / $606.51 / $606.51	Facility		$606.51	$606.51	$606.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.05 / $515.53 / $606.51	Professional		$112.05	$515.53	$606.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,561.74 / $3,633.30 / $3,940.72	Professional		$3,561.74	$3,633.30	$3,940.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $701.28 / $1,223.53 / $1,514.75	Facility		$701.28	$1,223.53	$1,514.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $110.73 / $140.33 / $1,078.80	Professional		$110.73	$140.33	$1,078.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,186.68 / $2,545.98 / $2,803.95	Facility		$1,186.68	$2,545.98	$2,803.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,301.75 / $2,764.69 / $2,803.95	Professional		$2,301.75	$2,764.69	$2,803.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $445.72 / $1,030.00 / $1,627.15	Facility		$445.72	$1,030.00	$1,627.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.05 / $133.57 / $606.51	Professional		$112.05	$133.57	$606.51
United Facility/Professional Professional Modifier Low / Median / High Price $643.80 / $697.80 / $1,370.40	Professional		$643.80	$697.80	$1,370.40