Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $52.48 / $52.48	Facility		$46.77	$52.48	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $776.25	Professional		$46.77	$46.77	$776.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Professional		$34.67	$34.67	$34.67
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $102.33	Facility		$46.77	$46.77	$102.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $776.25	Professional		$46.77	$46.77	$776.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Facility		$1,071.52	$1,071.52	$1,071.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional		$1,071.52	$1,071.52	$1,071.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $776.25	Facility		$46.77	$46.77	$776.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $79.43	Professional		$60.26	$79.43	$79.43