Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $801.82 / $801.82 / $801.82	Facility		$801.82	$801.82	$801.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $492.35 / $640.32 / $1,005.44	Professional		$492.35	$640.32	$1,005.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $750.60 / $750.60 / $750.60	Professional		$750.60	$750.60	$750.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,749.66 / $2,047.60 / $2,528.79	Professional		$1,749.66	$2,047.60	$2,528.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $92.08 / $640.32 / $1,669.04	Facility		$92.08	$640.32	$1,669.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.20 / $107.77 / $209.24	Professional		$63.20	$107.77	$209.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,501.50 / $1,803.49 / $1,829.10	Facility		$1,501.50	$1,803.49	$1,829.10
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,501.50 / $1,803.49 / $1,829.10	Professional		$1,501.50	$1,803.49	$1,829.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $92.08 / $228.88 / $1,376.69	Facility		$92.08	$228.88	$1,376.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.02 / $115.92 / $750.60	Professional		$81.02	$115.92	$750.60
United Facility/Professional Professional Modifier Low / Median / High Price $60.85 / $73.40 / $272.86	Professional		$60.85	$73.40	$272.86