Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.32 / $59.90 / $64.23	Professional		$28.32	$59.90	$64.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.92 / $32.92 / $32.92	Professional		$32.92	$32.92	$32.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.37 / $145.97 / $174.47	Professional		$73.37	$145.97	$174.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $41.67 / $65.28 / $110.79	Facility		$41.67	$65.28	$110.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.08 / $69.70 / $77.04	Professional		$55.08	$69.70	$77.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $36.00 / $71.65 / $76.81	Facility		$36.00	$71.65	$76.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.67 / $65.72 / $110.79	Facility		$41.67	$65.72	$110.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.92 / $69.83 / $103.00	Professional		$32.92	$69.83	$103.00
United Facility/Professional Professional Modifier Low / Median / High Price $32.56 / $34.21 / $65.28	Professional		$32.56	$34.21	$65.28