Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $675.21 / $4,704.00 / $8,728.00	Facility		$675.21	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $485.34 / $681.43 / $775.72	Professional		$485.34	$681.43	$775.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $295.51 / $588.76 / $885.20	Facility		$295.51	$588.76	$885.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $387.16 / $591.23 / $631.14	Facility		$387.16	$591.23	$631.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $295.51 / $642.08 / $885.20	Facility		$295.51	$642.08	$885.20
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $473.27 / $473.27 / $473.27	Facility	62	$473.27	$473.27	$473.27
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $121.16 / $121.16 / $121.16	Facility	80	$121.16	$121.16	$121.16
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $102.98 / $102.98 / $102.98	Facility	AS	$102.98	$102.98	$102.98
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