Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $54.95 / $128.82	Facility		$44.67	$54.95	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $54.95	Professional		$43.65	$52.48	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $22.39 / $23.99	Professional		$9.33	$22.39	$23.99
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $11.22 / $77.62	Facility		$11.22	$11.22	$77.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $11.22 / $54.95	Professional		$11.22	$11.22	$54.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $56.23 / $56.23	Facility		$28.84	$56.23	$56.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $67.61 / $100.00	Facility		$34.67	$67.61	$100.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $54.95 / $79.43	Professional		$20.89	$54.95	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70