Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $283.74 / $4,704.00 / $8,728.00	Facility		$283.74	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.11 / $288.58 / $328.52	Professional		$204.11	$288.58	$328.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $125.15 / $246.86 / $371.15	Facility		$125.15	$246.86	$371.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $160.06 / $237.13 / $261.30	Facility		$160.06	$237.13	$261.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $125.15 / $269.22 / $371.15	Facility		$125.15	$269.22	$371.15
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