Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,953.60 / $11,652.00 / $23,856.49	Facility		$2,953.60	$11,652.00	$23,856.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,309.66 / $3,254.26 / $3,704.55	Professional		$2,309.66	$3,254.26	$3,704.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,411.25 / $2,797.87 / $4,206.58	Facility		$1,411.25	$2,797.87	$4,206.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,801.24 / $2,813.59 / $2,988.20	Facility		$1,801.24	$2,813.59	$2,988.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,411.25 / $3,051.24 / $4,206.58	Facility		$1,411.25	$3,051.24	$4,206.58
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,245.39 / $2,245.39 / $2,245.39	Facility	62	$2,245.39	$2,245.39	$2,245.39
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $574.82 / $574.82 / $574.82	Facility	80	$574.82	$574.82	$574.82
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $488.60 / $488.60 / $488.60	Facility	AS	$488.60	$488.60	$488.60
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