Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $87.10 / $114.82	Professional		$41.69	$87.10	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $218.78 / $275.42	Professional		$109.65	$218.78	$275.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $93.33 / $120.23	Facility		$67.61	$93.33	$120.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $87.10 / $114.82	Professional		$79.43	$87.10	$114.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $104.71 / $107.15	Facility		$100.00	$104.71	$107.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $104.71 / $120.23	Facility		$61.66	$104.71	$120.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.11 / $117.49	Professional		$50.12	$85.11	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $51.29 / $77.62	Professional		$46.77	$51.29	$77.62