Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $7,169.06 / $7,955.95	Facility		$2,747.00	$7,169.06	$7,955.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5,175.76 / $7,317.20 / $8,329.67	Professional		$5,175.76	$7,317.20	$8,329.67
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $3,173.19 / $6,264.62 / $9,418.83	Facility		$3,173.19	$6,264.62	$9,418.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,083.07 / $6,305.01 / $6,663.15	Facility		$4,083.07	$6,305.01	$6,663.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,173.19 / $6,831.94 / $9,418.83	Facility		$3,173.19	$6,831.94	$9,418.83
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $1,278.25 / $1,278.25 / $1,278.25	Facility	80	$1,278.25	$1,278.25	$1,278.25
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $1,086.51 / $1,086.51 / $1,086.51	Facility	AS	$1,086.51	$1,086.51	$1,086.51
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