Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $885.39 / $5,116.62 / $15,341.00	Facility		$885.39	$5,116.62	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $642.47 / $911.42 / $1,037.54	Professional		$642.47	$911.42	$1,037.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $395.25 / $776.20 / $1,167.02	Facility		$395.25	$776.20	$1,167.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $505.61 / $782.66 / $820.08	Facility		$505.61	$782.66	$820.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $395.25 / $846.50 / $1,167.02	Facility		$395.25	$846.50	$1,167.02
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $134.54 / $134.54 / $134.54	Facility	AS	$134.54	$134.54	$134.54
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