Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,263.52 / $1,263.52 / $1,263.52	Facility		$1,263.52	$1,263.52	$1,263.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $739.98 / $848.34 / $1,263.52	Professional		$739.98	$848.34	$1,263.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,042.44 / $1,042.44 / $1,042.44	Facility		$1,042.44	$1,042.44	$1,042.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.94 / $886.07 / $1,042.44	Professional		$119.94	$886.07	$1,042.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,661.33 / $3,734.89 / $4,050.88	Professional		$3,661.33	$3,734.89	$4,050.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $147.93 / $629.79 / $1,810.80	Facility		$147.93	$629.79	$1,810.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $111.23 / $112.04 / $148.03	Professional		$111.23	$112.04	$148.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,366.10 / $2,841.99 / $2,882.34	Facility		$2,366.10	$2,841.99	$2,882.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,366.10 / $2,841.99 / $2,882.34	Professional		$2,366.10	$2,841.99	$2,882.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.03 / $464.63 / $1,810.80	Facility		$102.03	$464.63	$1,810.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $119.94 / $140.90 / $886.07	Professional		$119.94	$140.90	$886.07
United Facility/Professional Professional Modifier Low / Median / High Price $601.17 / $714.14 / $1,190.24	Professional		$601.17	$714.14	$1,190.24