Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $11,652.00 / $23,856.49	Facility		$2,747.00	$11,652.00	$23,856.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,077.54 / $2,927.79 / $3,332.90	Professional		$2,077.54	$2,927.79	$3,332.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,269.67 / $2,516.11 / $3,782.97	Facility		$1,269.67	$2,516.11	$3,782.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,652.68 / $2,530.82 / $2,704.12	Facility		$1,652.68	$2,530.82	$2,704.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,269.67 / $2,743.97 / $3,782.97	Facility		$1,269.67	$2,743.97	$3,782.97
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $517.39 / $517.39 / $517.39	Facility	80	$517.39	$517.39	$517.39
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $439.78 / $439.78 / $439.78	Facility	AS	$439.78	$439.78	$439.78
United Facility/Professional Facility Modifier Low / Median / High Price $2,364.00 / $8,571.00 / $36,803.00	Facility		$2,364.00	$8,571.00	$36,803.00