Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $831.76 / $7,943.28	Facility		$288.40	$831.76	$7,943.28
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,621.81 / $1,621.81 / $3,388.44	Facility	50	$1,621.81	$1,621.81	$3,388.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $489.78 / $933.25	Professional	50	$147.91	$489.78	$933.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $288.40 / $645.65	Professional		$204.17	$288.40	$645.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $275.42 / $602.56	Facility		$128.82	$275.42	$602.56
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,621.81 / $1,621.81 / $3,388.44	Facility	50	$1,621.81	$1,621.81	$3,388.44
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $100.00 / $407.38 / $1,174.90	Professional	50	$100.00	$407.38	$1,174.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $467.74 / $489.78	Facility		$346.74	$467.74	$489.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $275.42 / $537.03	Facility		$128.82	$275.42	$537.03
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