Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.79 / $86.79 / $86.79	Professional		$86.79	$86.79	$86.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.50 / $67.41 / $120.44	Professional		$53.50	$67.41	$120.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $50.39 / $69.68 / $78.28	Facility		$50.39	$69.68	$78.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $92.93 / $92.93 / $126.00	Facility		$92.93	$92.93	$126.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.83 / $80.26 / $107.82	Professional		$62.83	$80.26	$107.82