Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $442.09 / $4,684.68 / $8,728.00	Facility		$442.09	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $378.13 / $555.54 / $3,054.15	Professional		$378.13	$555.54	$3,054.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $270.22 / $1,158.36 / $5,037.89	Facility		$270.22	$1,158.36	$5,037.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $418.75 / $2,399.36 / $4,229.39	Facility		$418.75	$2,399.36	$4,229.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $270.22 / $2,343.21 / $5,037.89	Facility		$270.22	$2,343.21	$5,037.89
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00