Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.60 / $2,438.10 / $6,923.95	Facility		$194.60	$2,438.10	$6,923.95
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.30 / $116.14 / $1,329.30	Facility	52	$97.30	$116.14	$1,329.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $178.10 / $1,070.40 / $2,553.35	Professional		$178.10	$1,070.40	$2,553.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $143.16 / $1,070.40 / $3,577.44	Facility		$143.16	$1,070.40	$3,577.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $194.58 / $1,994.99 / $2,628.52	Facility		$194.58	$1,994.99	$2,628.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $143.16 / $2,020.65 / $3,570.00	Facility		$143.16	$2,020.65	$3,570.00
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