Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $4,343.77 / $7,920.26	Facility		$2,747.00	$4,343.77	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,829.45 / $4,013.77 / $4,569.14	Professional		$2,829.45	$4,013.77	$4,569.14
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,392.96 / $3,609.17 / $5,158.37	Facility		$2,392.96	$3,609.17	$5,158.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,595.46 / $3,446.78 / $3,664.52	Facility		$2,595.46	$3,446.78	$3,664.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,392.96 / $3,951.65 / $5,158.37	Facility		$2,392.96	$3,951.65	$5,158.37
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $694.31 / $694.31 / $694.31	Facility	80	$694.31	$694.31	$694.31
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $590.16 / $590.16 / $590.16	Facility	AS	$590.16	$590.16	$590.16
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $7,664.00 / $36,803.00	Facility		$2,364.00	$7,664.00	$36,803.00