Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,630.36 / $1,630.36 / $1,630.36	Facility		$1,630.36	$1,630.36	$1,630.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $901.44 / $901.44 / $1,630.36	Professional		$901.44	$901.44	$1,630.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $504.00 / $504.00 / $504.00	Facility		$504.00	$504.00	$504.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.11 / $428.40 / $504.00	Professional		$141.11	$428.40	$504.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,724.32 / $4,819.24 / $5,227.00	Professional		$4,724.32	$4,819.24	$5,227.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $901.44 / $1,795.40 / $2,454.10	Facility		$901.44	$1,795.40	$2,454.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $151.01 / $296.16 / $1,471.18	Professional		$151.01	$296.16	$1,471.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,877.59 / $2,197.25 / $2,676.65	Facility		$1,877.59	$2,197.25	$2,676.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,197.25 / $2,676.65 / $2,676.65	Professional		$2,197.25	$2,676.65	$2,676.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $504.00 / $1,795.40 / $3,115.29	Facility		$504.00	$1,795.40	$3,115.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.11 / $172.46 / $504.00	Professional		$141.11	$172.46	$504.00
United Facility/Professional Professional Modifier Low / Median / High Price $897.00 / $1,222.15 / $1,794.00	Professional		$897.00	$1,222.15	$1,794.00