Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $67.61 / $81.28	Professional		$58.88	$67.61	$81.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $194.98	Professional		$125.89	$162.18	$194.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $87.10 / $147.91	Facility		$63.10	$87.10	$147.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $66.07 / $85.11	Professional		$52.48	$66.07	$85.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $147.91 / $154.88	Facility		$102.33	$147.91	$154.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $85.11 / $144.54	Facility		$60.26	$85.11	$144.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $223.87	Professional		$70.79	$79.43	$223.87