Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.99 / $4,684.68 / $8,728.00	Facility		$269.99	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $231.61 / $340.29 / $1,853.88	Professional		$231.61	$340.29	$1,853.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $162.97 / $357.28 / $2,017.71	Facility		$162.97	$357.28	$2,017.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $239.86 / $1,412.18 / $1,572.35	Facility		$239.86	$1,412.18	$1,572.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.97 / $777.17 / $2,032.84	Facility		$162.97	$777.17	$2,032.84
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