Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.66 / $4,684.68 / $8,728.00	Facility		$93.66	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.89 / $100.11 / $671.85	Professional		$74.89	$100.11	$671.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $53.28 / $271.64 / $770.96	Facility		$53.28	$271.64	$770.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $71.81 / $562.66 / $773.14	Facility		$71.81	$562.66	$773.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.28 / $361.04 / $793.74	Facility		$53.28	$361.04	$793.74
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00