Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.93 / $4,704.00 / $8,728.00	Facility		$166.93	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.79 / $167.39 / $188.46	Professional		$118.79	$167.39	$188.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $112.89 / $160.94 / $242.71	Facility		$112.89	$160.94	$242.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $103.79 / $142.71 / $150.96	Facility		$103.79	$142.71	$150.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.89 / $178.45 / $242.71	Facility		$112.89	$178.45	$242.71
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