Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $522.72 / $8,369.76 / $20,400.00	Facility		$522.72	$8,369.76	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $376.54 / $534.16 / $601.41	Professional		$376.54	$534.16	$601.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $324.06 / $498.11 / $696.73	Facility		$324.06	$498.11	$696.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $329.71 / $447.46 / $481.73	Facility		$329.71	$447.46	$481.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $324.06 / $530.89 / $666.43	Facility		$324.06	$530.89	$666.43
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $91.61 / $91.61 / $91.61	Facility	80	$91.61	$91.61	$91.61
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $77.87 / $77.87 / $77.87	Facility	AS	$77.87	$77.87	$77.87
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