Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $494.38 / $4,684.68 / $8,728.00	Facility		$494.38	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $359.60 / $512.42 / $576.94	Professional		$359.60	$512.42	$576.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $298.41 / $482.00 / $646.07	Facility		$298.41	$482.00	$646.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $335.11 / $438.06 / $474.36	Facility		$335.11	$438.06	$474.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $298.41 / $556.92 / $641.58	Facility		$298.41	$556.92	$641.58
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $89.16 / $89.16 / $89.16	Facility	80	$89.16	$89.16	$89.16
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $75.79 / $75.79 / $75.79	Facility	AS	$75.79	$75.79	$75.79
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