Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.46 / $765.00 / $6,629.40	Facility		$135.46	$765.00	$6,629.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $67.73 / $80.95 / $149.60	Facility	52	$67.73	$80.95	$149.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.88 / $182.16 / $289.95	Professional		$122.88	$182.16	$289.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $99.72 / $190.69 / $356.15	Facility		$99.72	$190.69	$356.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.27 / $218.89 / $241.20	Facility		$120.27	$218.89	$241.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $99.72 / $190.69 / $356.15	Facility		$99.72	$190.69	$356.15
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $4,113.00 / $6,216.00	Facility		$376.00	$4,113.00	$6,216.00