Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $221.43 / $4,684.68 / $8,728.00	Facility		$221.43	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $211.24 / $256.64	Professional		$170.00	$211.24	$256.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $117.43 / $187.68 / $281.38	Facility		$117.43	$187.68	$281.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $146.80 / $195.97 / $205.69	Facility		$146.80	$195.97	$205.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $118.62 / $208.14 / $281.38	Facility		$118.62	$208.14	$281.38
United Facility/Professional Facility Modifier Low / Median / High Price $177.00 / $1,078.00 / $5,183.00	Facility		$177.00	$1,078.00	$5,183.00