Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $5,152.30 / $7,920.26	Facility		$2,747.00	$5,152.30	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,723.90 / $5,268.83 / $5,997.87	Professional		$3,723.90	$5,268.83	$5,997.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,284.89 / $4,505.93 / $6,774.67	Facility		$2,284.89	$4,505.93	$6,774.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,873.90 / $4,536.38 / $4,789.83	Facility		$2,873.90	$4,536.38	$4,789.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,284.89 / $4,914.00 / $6,774.67	Facility		$2,284.89	$4,914.00	$6,774.67
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $918.63 / $918.63 / $918.63	Facility	80	$918.63	$918.63	$918.63
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $780.84 / $780.84 / $780.84	Facility	AS	$780.84	$780.84	$780.84
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