Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,373.37 / $1,373.37 / $1,373.37	Facility		$1,373.37	$1,373.37	$1,373.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $759.96 / $759.96 / $1,373.37	Professional		$759.96	$759.96	$1,373.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.26 / $642.26 / $642.26	Facility		$642.26	$642.26	$642.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.88 / $545.91 / $642.26	Professional		$118.88	$545.91	$642.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,979.62 / $4,059.58 / $4,403.07	Professional		$3,979.62	$4,059.58	$4,403.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $759.96 / $1,409.38 / $1,744.66	Facility		$759.96	$1,409.38	$1,744.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $127.55 / $161.66 / $1,242.66	Professional		$127.55	$161.66	$1,242.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,585.94 / $1,851.30 / $2,255.21	Facility		$1,585.94	$1,851.30	$2,255.21
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,851.30 / $2,255.21 / $2,255.21	Professional		$1,851.30	$2,255.21	$2,255.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $513.41 / $1,127.50 / $1,874.29	Facility		$513.41	$1,127.50	$1,874.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $118.88 / $145.40 / $642.26	Professional		$118.88	$145.40	$642.26
United Facility/Professional Professional Modifier Low / Median / High Price $748.56 / $756.24 / $1,468.60	Professional		$748.56	$756.24	$1,468.60