Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.92 / $63.10	Professional		$19.95	$26.92	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $51.29 / $61.66	Professional		$41.69	$51.29	$61.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $32.36 / $57.54	Facility		$21.38	$32.36	$57.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.70 / $50.12	Professional		$19.95	$25.70	$50.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $47.86 / $48.98	Facility		$33.88	$47.86	$48.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $32.36 / $53.70	Facility		$21.38	$32.36	$53.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $67.61 / $79.43	Professional		$39.81	$67.61	$79.43