Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $87.47 / $93.80	Professional		$42.44	$87.47	$93.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.33 / $49.33 / $49.33	Professional		$49.33	$49.33	$49.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.12 / $218.60 / $261.27	Professional		$107.12	$218.60	$261.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $60.84 / $97.20 / $161.75	Facility		$60.84	$97.20	$161.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $80.43 / $101.76 / $112.48	Professional		$80.43	$101.76	$112.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $102.78 / $107.12	Facility		$49.00	$102.78	$107.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.84 / $101.96 / $185.32	Facility		$60.84	$101.96	$185.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.33 / $101.96 / $118.45	Professional		$49.33	$101.96	$118.45
United Facility/Professional Professional Modifier Low / Median / High Price $48.26 / $51.28 / $97.83	Professional		$48.26	$51.28	$97.83