Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.59 / $68.42 / $69.91	Professional		$32.59	$68.42	$69.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.88 / $37.88 / $37.88	Professional		$37.88	$37.88	$37.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.46 / $167.34 / $199.99	Professional		$84.46	$167.34	$199.99
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.97 / $73.15 / $127.53	Facility		$47.97	$73.15	$127.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.42 / $76.01 / $88.68	Professional		$63.42	$76.01	$88.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $36.00 / $82.48 / $102.28	Facility		$36.00	$82.48	$102.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.97 / $74.90 / $127.53	Facility		$47.97	$74.90	$127.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $37.88 / $80.39 / $103.00	Professional		$37.88	$80.39	$103.00
United Facility/Professional Professional Modifier Low / Median / High Price $37.06 / $39.36 / $65.62	Professional		$37.06	$39.36	$65.62