Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility		$1,819.70	$1,819.70	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,380.38 / $2,290.87	Professional		$1,148.15	$1,380.38	$2,290.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Facility		$1,071.52	$1,071.52	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $912.01 / $1,071.52	Professional		$162.18	$912.01	$1,071.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $5,011.87 / $5,623.41	Professional		$4,168.69	$5,011.87	$5,623.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $223.87 / $1,819.70	Facility		$173.78	$223.87	$1,819.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,737.80 / $1,819.70	Professional		$1,698.24	$1,737.80	$1,819.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $3,235.94 / $3,890.45	Facility		$1,949.84	$3,235.94	$3,890.45
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $3,890.45 / $3,890.45	Professional		$3,235.94	$3,890.45	$3,890.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,202.26 / $2,691,534.80	Facility		$234.42	$1,202.26	$2,691,534.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $912.01 / $1,288.25	Professional		$79.43	$912.01	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,148.15 / $1,548.82	Facility		$154.88	$1,148.15	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $977.24 / $1,621.81	Professional		$812.83	$977.24	$1,621.81