Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $91.59 / $99.64	Professional		$42.95	$91.59	$99.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $49.92 / $49.92	Professional		$49.92	$49.92	$49.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.19 / $220.75 / $263.83	Professional		$112.19	$220.75	$263.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.72 / $97.82 / $169.41	Facility		$63.72	$97.82	$169.41
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $84.22 / $103.00 / $117.80	Professional		$84.22	$103.00	$117.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $104.01 / $112.19	Facility		$49.00	$104.01	$112.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $65.95 / $100.78 / $194.09	Facility		$65.95	$100.78	$194.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $106.78 / $118.45	Professional		$49.92	$106.78	$118.45
United Facility/Professional Professional Modifier Low / Median / High Price $48.85 / $51.89 / $99.00	Professional		$48.85	$51.89	$99.00