Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.56 / $126.00 / $168.00	Facility		$104.56	$126.00	$168.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.00 / $72.83 / $84.91	Professional		$62.00	$72.83	$84.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $4,346.00 / $4,845.79 / $5,085.88	Facility		$4,346.00	$4,845.79	$5,085.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $104.00 / $138.00	Facility		$85.00	$104.00	$138.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.40 / $3,232.79 / $5,085.88	Facility		$81.40	$3,232.79	$5,085.88