Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $782.53 / $4,704.00 / $8,728.00	Facility		$782.53	$4,704.00	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $565.28 / $796.91 / $907.18	Professional		$565.28	$796.91	$907.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $345.59 / $681.45 / $1,024.56	Facility		$345.59	$681.45	$1,024.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $445.69 / $688.61 / $728.29	Facility		$445.69	$688.61	$728.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $345.59 / $743.16 / $1,024.56	Facility		$345.59	$743.16	$1,024.56
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $139.53 / $139.53 / $139.53	Facility	80	$139.53	$139.53	$139.53
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $118.60 / $118.60 / $118.60	Facility	AS	$118.60	$118.60	$118.60
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