Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $819.15 / $819.15 / $819.15	Facility		$819.15	$819.15	$819.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.46 / $549.96 / $819.15	Professional		$467.46	$549.96	$819.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.52 / $75.52 / $766.82	Professional		$75.52	$75.52	$766.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,373.64 / $2,421.33 / $2,626.19	Professional		$2,373.64	$2,421.33	$2,626.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $93.46 / $408.22 / $1,173.59	Facility		$93.46	$408.22	$1,173.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.28 / $73.79 / $93.51	Professional		$70.28	$73.79	$93.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,533.95 / $1,842.47 / $1,868.63	Facility		$1,533.95	$1,842.47	$1,868.63
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,533.95 / $1,842.47 / $1,868.63	Professional		$1,533.95	$1,842.47	$1,868.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.14 / $301.19 / $1,173.59	Facility		$66.14	$301.19	$1,173.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.52 / $89.00 / $109.58	Professional		$75.52	$89.00	$109.58
United Facility/Professional Professional Modifier Low / Median / High Price $390.88 / $462.96 / $925.92	Professional		$390.88	$462.96	$925.92