Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $55.77 / $66.04	Professional		$26.80	$55.77	$66.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.15 / $31.15 / $31.15	Professional		$31.15	$31.15	$31.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.43 / $138.13 / $165.12	Professional		$75.43	$138.13	$165.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.83 / $64.28 / $113.90	Facility		$42.83	$64.28	$113.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.62 / $71.66 / $79.20	Professional		$56.62	$71.66	$79.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.44 / $68.40 / $75.43	Facility		$35.44	$68.40	$75.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.83 / $65.31 / $113.90	Facility		$42.83	$65.31	$113.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.15 / $71.79 / $103.00	Professional		$31.15	$71.79	$103.00
United Facility/Professional Professional Modifier Low / Median / High Price $30.47 / $32.38 / $61.77	Professional		$30.47	$32.38	$61.77