Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $316.23	Professional		$169.82	$245.47	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $660.69 / $812.83	Professional		$512.86	$660.69	$812.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $309.03 / $512.86	Facility		$213.80	$309.03	$512.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $316.23	Professional		$169.82	$239.88	$316.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $602.56 / $630.96	Facility		$512.86	$602.56	$630.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $309.03 / $467.74	Facility		$204.17	$309.03	$467.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $912.01	Professional		$70.79	$79.43	$912.01