Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $626.35 / $4,704.00 / $8,728.00	Facility		$626.35	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $449.23 / $630.80 / $718.10	Professional		$449.23	$630.80	$718.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $273.56 / $546.69 / $821.95	Facility		$273.56	$546.69	$821.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $381.82 / $547.25 / $586.25	Facility		$381.82	$547.25	$586.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $273.56 / $596.20 / $821.95	Facility		$273.56	$596.20	$821.95
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