Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
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 $39.81 / $39.81 / $61.66	Facility		$39.81	$39.81	$61.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $61.66	Facility		$39.81	$39.81	$61.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $141.25	Professional		$79.43	$141.25	$141.25