Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $565.38 / $4,704.00 / $8,728.00	Facility		$565.38	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $408.15 / $574.87 / $654.41	Professional		$408.15	$574.87	$654.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $249.30 / $494.05 / $742.80	Facility		$249.30	$494.05	$742.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $316.37 / $474.62 / $527.29	Facility		$316.37	$474.62	$527.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $249.30 / $538.79 / $742.80	Facility		$249.30	$538.79	$742.80
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $86.06 / $86.06 / $86.06	Facility	AS	$86.06	$86.06	$86.06
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00