Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $1,737.80 / $6,606.93	Facility		$302.00	$1,737.80	$6,606.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $380.19 / $1,905.46	Professional		$239.88	$380.19	$1,905.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,047.13 / $2,630.27	Facility		$199.53	$1,047.13	$2,630.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,479.11 / $1,584.89	Facility		$1,047.13	$1,479.11	$1,584.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $741.31 / $1,905.46	Facility		$199.53	$741.31	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $4,073.80 / $6,165.95	Facility		$389.05	$4,073.80	$6,165.95