Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.78 / $411.78 / $411.78	Facility		$411.78	$411.78	$411.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $384.24 / $419.28 / $447.15	Professional		$384.24	$419.28	$447.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $654.75 / $654.75 / $654.75	Facility		$654.75	$654.75	$654.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.35 / $654.75 / $1,410.10	Professional		$44.35	$654.75	$1,410.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,193.21 / $1,217.18 / $1,320.17	Professional		$1,193.21	$1,217.18	$1,320.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $403.45 / $1,485.36	Facility		$50.40	$403.45	$1,485.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.40 / $50.40 / $125.23	Professional		$38.40	$50.40	$125.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $771.10 / $926.19 / $1,259.79	Facility		$771.10	$926.19	$1,259.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $771.10 / $926.19 / $939.34	Professional		$771.10	$926.19	$939.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $403.45 / $1,485.36	Facility		$50.40	$403.45	$1,485.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.35 / $73.40 / $654.75	Professional		$44.35	$73.40	$654.75
United Facility/Professional Professional Modifier Low / Median / High Price $397.78 / $397.78 / $662.97	Professional		$397.78	$397.78	$662.97