Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.19 / $4,043.91 / $8,728.00	Facility		$97.19	$4,043.91	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.53 / $102.19 / $158.72	Professional		$69.53	$102.19	$158.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $56.45 / $97.75 / $179.01	Facility		$56.45	$97.75	$179.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.59 / $125.16 / $144.16	Facility		$79.59	$125.16	$144.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $59.96 / $101.64 / $217.97	Facility		$59.96	$101.64	$217.97
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $26.85 / $26.85 / $26.85	Facility	80	$26.85	$26.85	$26.85
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $22.82 / $22.82 / $22.82	Facility	AS	$22.82	$22.82	$22.82
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