Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.77 / $92.61 / $101.80	Professional		$43.77	$92.61	$101.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.89 / $50.89 / $50.89	Professional		$50.89	$50.89	$50.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $116.26 / $225.01 / $268.93	Professional		$116.26	$225.01	$268.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.04 / $100.37 / $175.55	Facility		$66.04	$100.37	$175.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.38 / $110.45 / $122.07	Professional		$87.38	$110.45	$122.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $109.35 / $116.26	Facility		$49.00	$109.35	$116.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.05 / $101.39 / $201.13	Facility		$67.05	$101.39	$201.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.89 / $103.00 / $121.08	Professional		$50.89	$103.00	$121.08
United Facility/Professional Professional Modifier Low / Median / High Price $50.33 / $52.89 / $100.91	Professional		$50.33	$52.89	$100.91