Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $102.79 / $110.24	Professional		$42.13	$102.79	$110.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.97 / $48.97 / $48.97	Professional		$48.97	$48.97	$48.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.90 / $216.48 / $263.92	Professional		$125.90	$216.48	$263.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $71.48 / $103.84 / $190.11	Facility		$71.48	$103.84	$190.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $94.52 / $119.61 / $132.19	Professional		$94.52	$119.61	$132.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $101.92 / $122.95 / $125.90	Facility		$101.92	$122.95	$125.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $89.66 / $89.66 / $96.64	Professional		$89.66	$89.66	$96.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $71.48 / $109.03 / $200.60	Facility		$71.48	$109.03	$200.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.97 / $103.00 / $131.11	Professional		$48.97	$103.00	$131.11
United Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $50.90 / $97.11	Professional		$48.44	$50.90	$97.11