Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $827.37 / $827.37 / $827.37	Facility		$827.37	$827.37	$827.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $472.20 / $477.78 / $827.37	Professional		$472.20	$477.78	$827.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $458.33 / $458.33 / $458.33	Facility		$458.33	$458.33	$458.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.66 / $458.32 / $458.33	Professional		$75.66	$458.32	$458.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,397.46 / $2,445.63 / $2,652.56	Professional		$2,397.46	$2,445.63	$2,652.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $472.20 / $944.60 / $1,208.48	Facility		$472.20	$944.60	$1,208.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $76.86 / $138.44 / $726.03	Professional		$76.86	$138.44	$726.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $798.64 / $1,713.75 / $1,887.39	Facility		$798.64	$1,713.75	$1,887.39
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,549.35 / $1,860.97 / $1,887.39	Professional		$1,549.35	$1,860.97	$1,887.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $268.89 / $911.05 / $1,456.20	Facility		$268.89	$911.05	$1,456.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.66 / $89.91 / $458.32	Professional		$75.66	$89.91	$458.32
United Facility/Professional Professional Modifier Low / Median / High Price $470.76 / $470.76 / $922.50	Professional		$470.76	$470.76	$922.50