Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,602.67 / $11,652.00 / $23,856.49	Facility		$2,602.67	$11,652.00	$23,856.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,876.19 / $2,646.14 / $3,012.28	Professional		$1,876.19	$2,646.14	$3,012.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,147.53 / $2,277.09 / $3,423.60	Facility		$1,147.53	$2,277.09	$3,423.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,588.84 / $2,285.54 / $2,422.71	Facility		$1,588.84	$2,285.54	$2,422.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,147.53 / $2,483.30 / $3,423.60	Facility		$1,147.53	$2,483.30	$3,423.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $467.03 / $467.03 / $467.03	Facility	80	$467.03	$467.03	$467.03
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