Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $848.52 / $848.52 / $848.52	Facility		$848.52	$848.52	$848.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $569.76 / $569.76 / $848.52	Professional		$569.76	$569.76	$848.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.00 / $134.00 / $134.00	Facility		$134.00	$134.00	$134.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $113.90 / $134.00	Professional		$78.23	$113.90	$134.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,458.75 / $2,508.15 / $2,720.38	Professional		$2,458.75	$2,508.15	$2,720.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $113.91 / $422.98 / $1,216.08	Facility		$113.91	$422.98	$1,216.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.66 / $86.27 / $113.97	Professional		$85.66	$86.27	$113.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,588.95 / $1,908.53 / $1,935.63	Facility		$1,588.95	$1,908.53	$1,935.63
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,588.95 / $1,908.53 / $1,935.63	Professional		$1,588.95	$1,908.53	$1,935.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.53 / $312.02 / $1,216.08	Facility		$68.53	$312.02	$1,216.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.81 / $108.48 / $134.00	Professional		$91.81	$108.48	$134.00
United Facility/Professional Professional Modifier Low / Median / High Price $403.65 / $479.63 / $799.38	Professional		$403.65	$479.63	$799.38