Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,530.00 / $1,530.00 / $1,530.00	Facility		$1,530.00	$1,530.00	$1,530.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,495.00 / $2,495.00 / $2,495.00	Facility		$2,495.00	$2,495.00	$2,495.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $322.00	Facility		$200.00	$200.00	$322.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $425.00 / $425.00	Facility		$425.00	$425.00	$425.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $798.25 / $1,350.00	Facility		$500.00	$798.25	$1,350.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $735.00 / $1,508.00	Facility		$400.00	$735.00	$1,508.00
United Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $1,454.00 / $1,454.00	Facility		$700.00	$1,454.00	$1,454.00