Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,199.79 / $1,199.79 / $1,199.79	Facility		$1,199.79	$1,199.79	$1,199.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $663.48 / $663.48 / $1,199.79	Professional		$663.48	$663.48	$1,199.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $867.37 / $867.37 / $867.37	Facility		$867.37	$867.37	$867.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.85 / $737.26 / $867.37	Professional		$103.85	$737.26	$867.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,476.63 / $3,546.48 / $3,846.57	Professional		$3,476.63	$3,546.48	$3,846.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $663.48 / $1,228.75 / $1,521.39	Facility		$663.48	$1,228.75	$1,521.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $111.20 / $140.88 / $1,083.40	Professional		$111.20	$140.88	$1,083.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,382.68 / $1,617.00 / $1,969.80	Facility		$1,382.68	$1,617.00	$1,969.80
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,617.00 / $1,969.80 / $1,969.80	Professional		$1,617.00	$1,969.80	$1,969.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $447.62 / $1,040.40 / $1,634.07	Facility		$447.62	$1,040.40	$1,634.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.85 / $126.94 / $867.37	Professional		$103.85	$126.94	$867.37
United Facility/Professional Professional Modifier Low / Median / High Price $652.67 / $660.24 / $1,269.40	Professional		$652.67	$660.24	$1,269.40