Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $87.10	Facility		$63.10	$63.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $95.50	Professional		$63.10	$87.10	$95.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $47.86 / $134.90	Professional		$44.67	$47.86	$134.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $93.33 / $6,760.83	Facility		$89.13	$93.33	$6,760.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $87.10 / $87.10	Professional		$81.28	$87.10	$87.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $70.79	Facility		$69.18	$69.18	$70.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $93.33 / $6,760.83	Facility		$87.10	$93.33	$6,760.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $16.98 / $79.43	Professional		$16.98	$16.98	$79.43