Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $109.65 / $128.82	Professional		$52.48	$109.65	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $275.42 / $346.74	Professional		$134.90	$275.42	$346.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $151.36	Facility		$100.00	$100.00	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $107.15 / $141.25	Professional		$100.00	$107.15	$141.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $131.83 / $147.91	Facility		$128.82	$131.83	$147.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $123.03 / $165.96	Facility		$85.11	$123.03	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $100.00 / $125.89	Professional		$63.10	$100.00	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $64.57 / $102.33	Professional		$58.88	$64.57	$102.33