Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $173.78 / $208.93	Professional		$151.36	$173.78	$208.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $114.82	Facility		$75.86	$75.86	$114.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $114.82	Facility		$75.86	$75.86	$114.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $97.72 / $97.72	Professional		$79.43	$97.72	$97.72