Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.60 / $100.85 / $125.59	Professional		$49.60	$100.85	$125.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $57.66 / $57.66	Professional		$57.66	$57.66	$57.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.53 / $254.93 / $304.69	Professional		$123.53	$254.93	$304.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.14 / $106.97 / $186.53	Facility		$70.14	$106.97	$186.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $92.72 / $103.00 / $129.71	Professional		$92.72	$103.00	$129.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $120.12 / $123.53	Facility		$49.00	$120.12	$123.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $78.39 / $114.33 / $213.71	Facility		$78.39	$114.33	$213.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $117.57 / $128.63	Professional		$57.66	$117.57	$128.63
United Facility/Professional Professional Modifier Low / Median / High Price $57.02 / $59.93 / $114.33	Professional		$57.02	$59.93	$114.33