Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,757.24 / $5,116.62 / $20,400.00	Facility		$1,757.24	$5,116.62	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,284.52 / $1,827.92 / $2,080.85	Professional		$1,284.52	$1,827.92	$2,080.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $792.70 / $1,537.64 / $2,311.83	Facility		$792.70	$1,537.64	$2,311.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $984.90 / $1,486.61 / $1,641.50	Facility		$984.90	$1,486.61	$1,641.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $792.70 / $1,676.88 / $2,311.83	Facility		$792.70	$1,676.88	$2,311.83
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $265.81 / $265.81 / $265.81	Facility	AS	$265.81	$265.81	$265.81
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