Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.74 / $85.74 / $85.74	Facility		$85.74	$85.74	$85.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.87 / $195.96 / $234.96	Professional		$167.87	$195.96	$234.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $76.93 / $122.04 / $229.32	Facility		$76.93	$122.04	$229.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $132.75 / $181.81 / $198.59	Facility		$132.75	$181.81	$198.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $85.78 / $134.24 / $238.55	Facility		$85.78	$134.24	$238.55