Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.21 / $43.91 / $47.71	Professional		$22.21	$43.91	$47.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.82 / $25.82 / $25.82	Professional		$25.82	$25.82	$25.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.79 / $113.93 / $136.18	Professional		$53.79	$113.93	$136.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.55 / $53.13 / $81.22	Facility		$30.55	$53.13	$81.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.38 / $51.10 / $56.48	Professional		$40.38	$51.10	$56.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $23.50 / $52.53 / $68.18	Facility		$23.50	$52.53	$68.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.55 / $51.20 / $81.22	Facility		$30.55	$51.20	$81.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.82 / $51.20 / $71.75	Professional		$25.82	$51.20	$71.75
United Facility/Professional Professional Modifier Low / Median / High Price $25.54 / $26.83 / $51.20	Professional		$25.54	$26.83	$51.20