Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $531.61 / $531.61 / $531.61	Facility		$531.61	$531.61	$531.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.64 / $347.64 / $531.61	Professional		$347.64	$347.64	$531.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $459.79 / $459.79 / $459.79	Facility		$459.79	$459.79	$459.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.73 / $390.82 / $459.79	Professional		$50.73	$390.82	$459.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,540.46 / $1,571.41 / $1,704.36	Professional		$1,540.46	$1,571.41	$1,704.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $96.70 / $476.27 / $1,121.06	Facility		$96.70	$476.27	$1,121.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.49 / $572.16 / $762.90	Professional		$61.49	$572.16	$762.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $948.59 / $1,101.13 / $1,212.70	Facility		$948.59	$1,101.13	$1,212.70
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $995.50 / $1,195.72 / $1,212.70	Professional		$995.50	$1,195.72	$1,212.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $96.70 / $459.79 / $1,121.06	Facility		$96.70	$459.79	$1,121.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.73 / $66.48 / $459.79	Professional		$50.73	$66.48	$459.79
United Facility/Professional Professional Modifier Low / Median / High Price $294.06 / $294.06 / $588.12	Professional		$294.06	$294.06	$588.12