Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.69 / $56.39 / $67.25	Professional		$27.69	$56.39	$67.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.19 / $32.19 / $32.19	Professional		$32.19	$32.19	$32.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.80 / $142.41 / $170.22	Professional		$76.80	$142.41	$170.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $43.61 / $66.52 / $115.97	Facility		$43.61	$66.52	$115.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $72.95 / $80.64	Professional		$57.66	$72.95	$80.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $36.00 / $75.00 / $77.34	Facility		$36.00	$75.00	$77.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $54.69 / $54.69 / $54.69	Professional		$54.69	$54.69	$54.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $43.61 / $66.58 / $115.97	Facility		$43.61	$66.58	$115.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.19 / $73.09 / $103.00	Professional		$32.19	$73.09	$103.00
United Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $33.46 / $63.83	Professional		$31.84	$33.46	$63.83