Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Facility		$44.67	$44.67	$44.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $87.10	Professional		$33.11	$53.70	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $104.71	Professional		$77.62	$87.10	$104.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $51.29 / $97.72	Facility		$33.11	$51.29	$97.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $97.72	Professional		$33.11	$52.48	$97.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $77.62 / $79.43	Facility		$54.95	$77.62	$79.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $53.70 / $97.72	Facility		$35.48	$53.70	$97.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $114.82	Professional		$66.07	$85.11	$114.82