Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $1,122.02 / $1,122.02	Facility		$239.88	$1,122.02	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $1,122.02	Professional		$239.88	$239.88	$1,122.02
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 $239.88 / $239.88 / $660.69	Facility		$239.88	$239.88	$660.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $660.69	Professional		$239.88	$239.88	$660.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $1,122.02	Facility		$239.88	$239.88	$1,122.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $79.43	Professional		$60.26	$79.43	$79.43