Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.29 / $115.26 / $150.54	Professional		$58.29	$115.26	$150.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.76 / $67.76 / $67.76	Professional		$67.76	$67.76	$67.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.16 / $299.77 / $358.31	Professional		$141.16	$299.77	$358.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $80.17 / $122.25 / $213.15	Facility		$80.17	$122.25	$213.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $105.98 / $111.73 / $148.22	Professional		$105.98	$111.73	$148.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.50 / $137.85 / $141.16	Facility		$47.50	$137.85	$141.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $100.52 / $100.52 / $100.52	Professional		$100.52	$100.52	$100.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.60 / $134.36 / $244.21	Facility		$89.60	$134.36	$244.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.76 / $118.45 / $147.01	Professional		$67.76	$118.45	$147.01
United Facility/Professional Professional Modifier Low / Median / High Price $67.01 / $70.42 / $134.36	Professional		$67.01	$70.42	$134.36