Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.13 / $107.60 / $113.20	Professional		$50.13	$107.60	$113.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.28 / $58.28 / $58.28	Professional		$58.28	$58.28	$58.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.79 / $257.79 / $308.10	Professional		$131.79	$257.79	$308.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $74.84 / $114.14 / $199.00	Facility		$74.84	$114.14	$199.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $99.04 / $125.20 / $138.38	Professional		$99.04	$125.20	$138.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $118.56 / $128.69 / $133.55	Facility		$118.56	$128.69	$133.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.84 / $116.85 / $228.00	Facility		$74.84	$116.85	$228.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.28 / $109.80 / $154.44	Professional		$58.28	$109.80	$154.44
United Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $60.57 / $115.56	Professional		$57.01	$60.57	$115.56