Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $821.20 / $821.20 / $821.20	Facility		$821.20	$821.20	$821.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $528.17 / $551.34 / $821.20	Professional		$528.17	$551.34	$821.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.70 / $75.70 / $768.75	Professional		$75.70	$75.70	$768.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,379.60 / $2,427.41 / $2,632.81	Professional		$2,379.60	$2,427.41	$2,632.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $105.59 / $409.21 / $1,177.20	Facility		$105.59	$409.21	$1,177.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $79.97 / $105.66	Professional		$79.40	$79.97	$105.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,537.80 / $1,847.09 / $1,873.32	Facility		$1,537.80	$1,847.09	$1,873.32
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,537.80 / $1,847.09 / $1,873.32	Professional		$1,537.80	$1,847.09	$1,873.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.31 / $301.95 / $1,177.20	Facility		$66.31	$301.95	$1,177.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.70 / $100.57 / $123.82	Professional		$75.70	$100.57	$123.82
United Facility/Professional Professional Modifier Low / Median / High Price $391.96 / $464.26 / $773.76	Professional		$391.96	$464.26	$773.76