Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.78 / $56.90 / $66.94	Professional		$28.78	$56.90	$66.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.45 / $33.45 / $33.45	Professional		$33.45	$33.45	$33.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.69 / $148.12 / $177.02	Professional		$69.69	$148.12	$177.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $39.58 / $62.72 / $105.23	Facility		$39.58	$62.72	$105.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $58.06 / $73.17	Professional		$52.00	$58.06	$73.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $23.50 / $68.05 / $92.91	Facility		$23.50	$68.05	$92.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.58 / $63.23 / $105.23	Facility		$39.58	$63.23	$105.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.45 / $66.33 / $72.58	Professional		$33.45	$66.33	$72.58
United Facility/Professional Professional Modifier Low / Median / High Price $32.72 / $34.76 / $66.33	Professional		$32.72	$34.76	$66.33