Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $826.16 / $2,747.00 / $7,920.26	Facility		$826.16	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $645.14 / $912.05 / $1,038.25	Professional		$645.14	$912.05	$1,038.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $395.52 / $785.54 / $1,181.06	Facility		$395.52	$785.54	$1,181.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $578.30 / $785.90 / $831.20	Facility		$578.30	$785.90	$831.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $395.52 / $856.68 / $1,181.06	Facility		$395.52	$856.68	$1,181.06
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $624.33 / $624.33 / $624.33	Facility	62	$624.33	$624.33	$624.33
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $159.83 / $159.83 / $159.83	Facility	80	$159.83	$159.83	$159.83
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