Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,830.62 / $5,116.62 / $18,360.00	Facility		$3,830.62	$5,116.62	$18,360.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,080.62 / $4,403.87 / $4,958.32	Professional		$3,080.62	$4,403.87	$4,958.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2,224.34 / $3,468.86 / $4,918.10	Facility		$2,224.34	$3,468.86	$4,918.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,354.46 / $3,678.97 / $3,900.07	Facility		$2,354.46	$3,678.97	$3,900.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,224.34 / $4,606.81 / $4,952.10	Facility		$2,224.34	$4,606.81	$4,952.10
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $626.53 / $626.53 / $626.53	Facility	AS	$626.53	$626.53	$626.53
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00