Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.43 / $4,684.68 / $8,728.00	Facility		$139.43	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.34 / $445.44 / $1,177.92	Professional		$118.34	$445.44	$1,177.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $88.08 / $445.44 / $1,749.30	Facility		$88.08	$445.44	$1,749.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $125.29 / $922.65 / $1,302.48	Facility		$125.29	$922.65	$1,302.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $88.08 / $862.90 / $1,717.27	Facility		$88.08	$862.90	$1,717.27
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