Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $158.49	Professional		$85.11	$125.89	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $416.87	Professional		$263.03	$338.84	$416.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $158.49 / $269.15	Facility		$117.49	$158.49	$269.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $162.18	Professional		$81.28	$125.89	$162.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $309.03 / $323.59	Facility		$269.15	$309.03	$323.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $169.82 / $251.19	Facility		$102.33	$169.82	$251.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $467.74	Professional		$70.79	$79.43	$467.74