Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $527.20 / $527.20 / $527.20	Facility		$527.20	$527.20	$527.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $561.72 / $561.72 / $561.72	Professional		$561.72	$561.72	$561.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.69 / $251.69 / $251.69	Facility		$251.69	$251.69	$251.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.13 / $213.94 / $251.69	Professional		$88.13	$213.94	$251.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,527.67 / $1,558.36 / $1,690.22	Professional		$1,527.67	$1,558.36	$1,690.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $130.80 / $561.72 / $1,307.35	Facility		$130.80	$561.72	$1,307.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $82.26 / $963.02 / $1,032.22	Professional		$82.26	$963.02	$1,032.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $987.25 / $1,185.81 / $1,202.65	Facility		$987.25	$1,185.81	$1,202.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $987.25 / $1,185.81 / $1,202.65	Professional		$987.25	$1,185.81	$1,202.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $130.80 / $561.72 / $1,882.44	Facility		$130.80	$561.72	$1,882.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.13 / $107.45 / $251.69	Professional		$88.13	$107.45	$251.69
United Facility/Professional Professional Modifier Low / Median / High Price $388.69 / $500.87 / $695.85	Professional		$388.69	$500.87	$695.85