Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $325.16 / $4,684.68 / $8,728.00	Facility		$325.16	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $277.45 / $407.64 / $1,866.02	Professional		$277.45	$407.64	$1,866.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $199.27 / $428.43 / $2,056.59	Facility		$199.27	$428.43	$2,056.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $290.41 / $1,468.49 / $1,590.58	Facility		$290.41	$1,468.49	$1,590.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $199.27 / $782.26 / $2,056.59	Facility		$199.27	$782.26	$2,056.59
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