Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $81.28 / $85.11	Professional		$38.02	$81.28	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Professional		$44.67	$44.67	$44.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $199.53 / $251.19	Professional		$102.33	$199.53	$251.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $87.10 / $112.20	Facility		$63.10	$87.10	$112.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $107.15	Professional		$66.07	$81.28	$107.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $100.00 / $123.03	Facility		$97.72	$100.00	$123.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $89.13 / $104.71	Facility		$56.23	$89.13	$104.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $79.43 / $102.33	Professional		$45.71	$79.43	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $45.71 / $69.18	Professional		$39.81	$45.71	$69.18