Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $645.65 / $1,071.52	Professional		$575.44	$645.65	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $134.90	Professional		$77.62	$114.82	$134.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,454.71 / $2,754.23	Professional		$2,089.30	$2,454.71	$2,754.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $89.13 / $426.58	Facility		$87.10	$89.13	$426.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $676.08	Professional		$85.11	$85.11	$676.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,905.46 / $1,949.84	Facility		$1,584.89	$1,905.46	$1,949.84
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,905.46 / $1,949.84	Professional		$1,584.89	$1,905.46	$1,949.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $134.90 / $1,071.52	Facility		$69.18	$134.90	$1,071.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $134.90	Professional		$79.43	$114.82	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $562.34 / $758.58	Facility		$75.86	$562.34	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $478.63 / $794.33	Professional		$389.05	$478.63	$794.33