Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.86 / $39.31 / $42.11	Professional		$16.86	$39.31	$42.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.59 / $19.59 / $19.59	Professional		$19.59	$19.59	$19.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.06 / $86.87 / $105.92	Professional		$51.06	$86.87	$105.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.99 / $42.33 / $77.09	Facility		$28.99	$42.33	$77.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $37.58 / $48.51 / $53.61	Professional		$37.58	$48.51	$53.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $23.50 / $49.86 / $51.06	Facility		$23.50	$49.86	$51.06
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.99 / $44.22 / $77.09	Facility		$28.99	$44.22	$77.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.59 / $48.60 / $71.75	Professional		$19.59	$48.60	$71.75
United Facility/Professional Professional Modifier Low / Median / High Price $19.38 / $20.36 / $38.85	Professional		$19.38	$20.36	$38.85