Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $833.83 / $833.83 / $833.83	Facility		$833.83	$833.83	$833.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $559.79 / $559.79 / $833.83	Professional		$559.79	$559.79	$833.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $687.90 / $687.90 / $687.90	Facility		$687.90	$687.90	$687.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.87 / $584.72 / $687.90	Professional		$76.87	$584.72	$687.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,416.19 / $2,464.73 / $2,673.29	Professional		$2,416.19	$2,464.73	$2,673.29
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $111.93 / $415.60 / $1,195.20	Facility		$111.93	$415.60	$1,195.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $84.16 / $88.37 / $111.98	Professional		$84.16	$88.37	$111.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,561.45 / $1,875.50 / $1,902.13	Facility		$1,561.45	$1,875.50	$1,902.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,561.45 / $1,875.50 / $1,902.13	Professional		$1,561.45	$1,875.50	$1,902.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.33 / $306.58 / $1,195.20	Facility		$67.33	$306.58	$1,195.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $90.21 / $106.59 / $687.90	Professional		$90.21	$106.59	$687.90
United Facility/Professional Professional Modifier Low / Median / High Price $396.77 / $471.40 / $942.80	Professional		$396.77	$471.40	$942.80