Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $583.01 / $583.01 / $583.01	Facility		$583.01	$583.01	$583.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $515.94 / $515.94 / $583.01	Professional		$515.94	$515.94	$583.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $612.00 / $612.00 / $612.00	Facility		$612.00	$612.00	$612.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $612.00 / $1,474.15	Professional		$65.56	$612.00	$1,474.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,689.38 / $1,723.32 / $1,869.14	Professional		$1,689.38	$1,723.32	$1,869.14
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $80.50 / $515.94 / $1,393.92	Facility		$80.50	$515.94	$1,393.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.33 / $80.50 / $138.26	Professional		$61.33	$80.50	$138.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,091.75 / $1,311.33 / $1,390.88	Facility		$1,091.75	$1,311.33	$1,390.88
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,091.75 / $1,311.33 / $1,329.95	Professional		$1,091.75	$1,311.33	$1,329.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.50 / $515.94 / $1,393.92	Facility		$80.50	$515.94	$1,393.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $98.61 / $612.00	Professional		$65.56	$98.61	$612.00
United Facility/Professional Professional Modifier Low / Median / High Price $356.20 / $356.20 / $660.76	Professional		$356.20	$356.20	$660.76