Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.41 / $89.92 / $96.84	Professional		$44.41	$89.92	$96.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.62 / $51.62 / $51.62	Professional		$51.62	$51.62	$51.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $110.13 / $228.58 / $273.20	Professional		$110.13	$228.58	$273.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $62.55 / $101.02 / $166.30	Facility		$62.55	$101.02	$166.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $82.68 / $103.00 / $115.64	Professional		$82.68	$103.00	$115.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.50 / $107.55 / $110.13	Facility		$47.50	$107.55	$110.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.91 / $101.02 / $190.52	Facility		$69.91	$101.02	$190.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.62 / $104.82 / $118.45	Professional		$51.62	$104.82	$118.45
United Facility/Professional Professional Modifier Low / Median / High Price $51.06 / $53.66 / $102.37	Professional		$51.06	$53.66	$102.37