Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $364.87 / $5,116.62 / $20,400.00	Facility		$364.87	$5,116.62	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.52 / $371.58 / $422.99	Professional		$263.52	$371.58	$422.99
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $161.13 / $316.22 / $475.43	Facility		$161.13	$316.22	$475.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $203.01 / $306.27 / $338.35	Facility		$203.01	$306.27	$338.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $161.13 / $344.85 / $475.43	Facility		$161.13	$344.85	$475.43
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $55.37 / $55.37 / $55.37	Facility	AS	$55.37	$55.37	$55.37
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