Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $844.11 / $844.11 / $844.11	Facility		$844.11	$844.11	$844.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $481.74 / $566.76 / $844.11	Professional		$481.74	$566.76	$844.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $428.20 / $428.20 / $428.20	Facility		$428.20	$428.20	$428.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.83 / $363.97 / $428.20	Professional		$77.83	$363.97	$428.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,445.98 / $2,495.13 / $2,706.23	Professional		$2,445.98	$2,495.13	$2,706.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $96.32 / $420.76 / $1,209.59	Facility		$96.32	$420.76	$1,209.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $72.43 / $72.95 / $96.38	Professional		$72.43	$72.95	$96.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,580.70 / $1,898.62 / $1,925.58	Facility		$1,580.70	$1,898.62	$1,925.58
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,580.70 / $1,898.62 / $1,925.58	Professional		$1,580.70	$1,898.62	$1,925.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.17 / $310.41 / $1,209.59	Facility		$68.17	$310.41	$1,209.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.83 / $91.73 / $428.20	Professional		$77.83	$91.73	$428.20
United Facility/Professional Professional Modifier Low / Median / High Price $402.96 / $477.25 / $795.41	Professional		$402.96	$477.25	$795.41