Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $251.19 / $389.05	Facility		$204.17	$251.19	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $208.93 / $251.19	Professional		$186.21	$208.93	$251.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $4,897.79	Facility		$181.97	$181.97	$4,897.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $154.88 / $245.47	Facility		$107.15	$154.88	$245.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $4,466.84 / $6,309.57	Facility		$269.15	$4,466.84	$6,309.57