Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,764.36 / $2,764.36 / $2,764.36	Facility		$2,764.36	$2,764.36	$2,764.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,683.06 / $1,683.06 / $2,764.36	Professional		$1,683.06	$1,683.06	$2,764.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,225.09 / $2,225.09 / $2,225.09	Facility		$2,225.09	$2,225.09	$2,225.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.17 / $1,891.33 / $2,225.09	Professional		$246.17	$1,891.33	$2,225.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $8,010.31 / $8,171.25 / $8,862.62	Professional		$8,010.31	$8,171.25	$8,862.62
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $241.24 / $435.50 / $2,305.79	Facility		$241.24	$435.50	$2,305.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $229.24 / $235.14 / $308.63	Professional		$229.24	$235.14	$308.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,884.00 / $5,949.60 / $6,217.76	Facility		$4,884.00	$5,949.60	$6,217.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,884.00 / $5,949.60 / $5,949.60	Professional		$4,884.00	$5,949.60	$5,949.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $174.66 / $1,683.06 / $3,192.00	Facility		$174.66	$1,683.06	$3,192.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $247.52 / $321.88 / $2,225.09	Professional		$247.52	$321.88	$2,225.09
United Facility/Professional Professional Modifier Low / Median / High Price $1,106.56 / $1,159.59 / $2,213.12	Professional		$1,106.56	$1,159.59	$2,213.12