Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.55 / $108.56 / $116.43	Professional		$53.55	$108.56	$116.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.26 / $62.26 / $62.26	Professional		$62.26	$62.26	$62.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.97 / $275.58 / $329.35	Professional		$132.97	$275.58	$329.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $122.25 / $200.78	Facility		$75.51	$122.25	$200.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $99.81 / $110.78 / $139.62	Professional		$99.81	$110.78	$139.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $129.85 / $132.97 / $147.57	Facility		$129.85	$132.97	$147.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $122.27 / $230.04	Facility		$75.51	$122.27	$230.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.26 / $103.00 / $138.47	Professional		$62.26	$103.00	$138.47
United Facility/Professional Professional Modifier Low / Median / High Price $61.57 / $64.70 / $123.45	Professional		$61.57	$64.70	$123.45