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 $478.63 / $575.44 / $954.99	Professional		$478.63	$575.44	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $363.08 / $426.58	Professional		$77.62	$363.08	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,454.71 / $2,754.23	Professional		$2,041.74	$2,454.71	$2,754.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $416.87	Facility		$72.44	$72.44	$416.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $645.65	Professional		$72.44	$72.44	$645.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,905.46 / $1,905.46	Facility		$1,584.89	$1,905.46	$1,905.46
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,905.46 / $1,905.46	Professional		$1,584.89	$1,905.46	$1,905.46
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $416.87 / $1,071.52	Facility		$67.61	$416.87	$1,071.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $363.08 / $426.58	Professional		$79.43	$363.08	$426.58
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 $380.19 / $478.63 / $794.33	Professional		$380.19	$478.63	$794.33