Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,477.05 / $1,477.05 / $1,477.05	Facility		$1,477.05	$1,477.05	$1,477.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $837.90 / $837.90 / $1,477.05	Professional		$837.90	$837.90	$1,477.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $799.37 / $799.37 / $799.37	Facility		$799.37	$799.37	$799.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.31 / $679.46 / $799.37	Professional		$133.31	$679.46	$799.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,280.06 / $4,366.06 / $4,735.45	Professional		$4,280.06	$4,366.06	$4,735.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $837.90 / $1,696.20 / $2,598.85	Facility		$837.90	$1,696.20	$2,598.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $134.01 / $329.70 / $1,305.70	Professional		$134.01	$329.70	$1,305.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,666.40 / $3,059.44 / $3,369.43	Facility		$1,666.40	$3,059.44	$3,369.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,765.95 / $3,322.26 / $3,369.43	Professional		$2,765.95	$3,322.26	$3,369.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $539.46 / $1,696.20 / $3,299.04	Facility		$539.46	$1,696.20	$3,299.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $133.31 / $160.32 / $799.37	Professional		$133.31	$160.32	$799.37
United Facility/Professional Professional Modifier Low / Median / High Price $833.76 / $833.76 / $1,683.36	Professional		$833.76	$833.76	$1,683.36