Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $494.31 / $494.31 / $494.31	Facility		$494.31	$494.31	$494.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.77 / $331.86 / $494.31	Professional		$288.77	$331.86	$494.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.81 / $407.81 / $407.81	Facility		$407.81	$407.81	$407.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.24 / $346.64 / $407.81	Professional		$47.24	$346.64	$407.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,432.35 / $1,461.13 / $1,584.76	Professional		$1,432.35	$1,461.13	$1,584.76
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.34 / $246.16 / $708.48	Facility		$66.34	$246.16	$708.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $49.89 / $52.38 / $66.39	Professional		$49.89	$52.38	$66.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $925.65 / $1,111.82 / $1,127.60	Facility		$925.65	$1,111.82	$1,127.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $925.65 / $1,111.82 / $1,127.60	Professional		$925.65	$1,111.82	$1,127.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.90 / $181.71 / $708.48	Facility		$39.90	$181.71	$708.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.48 / $63.19 / $407.81	Professional		$53.48	$63.19	$407.81
United Facility/Professional Professional Modifier Low / Median / High Price $235.87 / $279.33 / $465.56	Professional		$235.87	$279.33	$465.56