Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $100.00 / $128.82	Professional		$48.98	$100.00	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $257.04 / $323.59	Professional		$125.89	$257.04	$323.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $107.15 / $141.25	Facility		$85.11	$107.15	$141.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $100.00 / $131.83	Professional		$91.20	$100.00	$131.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $120.23 / $123.03	Facility		$117.49	$120.23	$123.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $117.49 / $154.88	Facility		$77.62	$117.49	$154.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $97.72 / $117.49	Professional		$58.88	$97.72	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $91.20	Professional		$50.12	$60.26	$91.20