Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $23.99 / $54.95	Facility		$12.88	$23.99	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $12.88 / $19.95	Professional		$12.88	$12.88	$19.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $17.38 / $35.48	Facility		$12.30	$17.38	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $12.88 / $14.13	Professional		$12.88	$12.88	$14.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $33.11 / $38.90	Professional		$12.88	$33.11	$38.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $0.28 / $13.80 / $16.22	Facility		$0.28	$13.80	$16.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2.14 / $13.80 / $16.22	Professional		$2.14	$13.80	$16.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $19.05 / $31.62	Facility		$15.14	$19.05	$31.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $18.62 / $36.31	Facility		$12.88	$18.62	$36.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $15.14 / $79.43	Professional		$13.49	$15.14	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $12.88 / $14.79	Professional		$12.88	$12.88	$14.79