Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $67.93 / $72.86	Professional		$33.29	$67.93	$72.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.71 / $38.71 / $38.71	Professional		$38.71	$38.71	$38.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.21 / $171.61 / $205.10	Professional		$83.21	$171.61	$205.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.24 / $72.23 / $125.65	Facility		$47.24	$72.23	$125.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $62.46 / $79.05 / $98.00	Professional		$62.46	$79.05	$98.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $81.26 / $88.56	Facility		$49.00	$81.26	$88.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.24 / $76.89 / $143.94	Facility		$47.24	$76.89	$143.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.71 / $79.20 / $118.45	Professional		$38.71	$79.20	$118.45
United Facility/Professional Professional Modifier Low / Median / High Price $37.86 / $40.24 / $76.76	Professional		$37.86	$40.24	$76.76