Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.57 / $4,684.68 / $8,728.00	Facility		$193.57	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $140.16 / $203.87 / $266.68	Professional		$140.16	$203.87	$266.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.58 / $167.44 / $295.64	Facility		$108.58	$167.44	$295.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $149.91 / $212.61 / $239.94	Facility		$149.91	$212.61	$239.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $113.39 / $176.69 / $360.00	Facility		$113.39	$176.69	$360.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $44.97 / $44.97 / $44.97	Facility	80	$44.97	$44.97	$44.97
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $38.22 / $38.22 / $38.22	Facility	AS	$38.22	$38.22	$38.22
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