Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.44 / $103.37 / $111.50	Professional		$44.44	$103.37	$111.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.66 / $51.66 / $51.66	Professional		$51.66	$51.66	$51.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.33 / $228.58 / $275.55	Professional		$127.33	$228.58	$275.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.31 / $105.56 / $192.27	Facility		$72.31	$105.56	$192.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.60 / $106.09 / $133.69	Professional		$95.60	$106.09	$133.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $124.35 / $127.33 / $143.49	Facility		$124.35	$127.33	$143.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.31 / $110.28 / $212.50	Facility		$72.31	$110.28	$212.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.66 / $71.75 / $132.61	Professional		$51.66	$71.75	$132.61
United Facility/Professional Professional Modifier Low / Median / High Price $51.10 / $53.69 / $102.43	Professional		$51.10	$53.69	$102.43