Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.52 / $87.08 / $97.49	Professional		$37.52	$87.08	$97.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.62 / $43.62 / $43.62	Professional		$43.62	$43.62	$43.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.34 / $192.97 / $235.28	Professional		$111.34	$192.97	$235.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.22 / $96.42 / $168.12	Facility		$63.22	$96.42	$168.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.65 / $105.77 / $116.91	Professional		$83.65	$105.77	$116.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $100.21 / $111.34	Facility		$49.00	$100.21	$111.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.22 / $98.72 / $168.12	Facility		$63.22	$98.72	$168.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.62 / $71.75 / $115.95	Professional		$43.62	$71.75	$115.95
United Facility/Professional Professional Modifier Low / Median / High Price $41.92 / $45.34 / $86.49	Professional		$41.92	$45.34	$86.49