Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $443.64 / $4,684.68 / $8,728.00	Facility		$443.64	$4,684.68	$8,728.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $355.59 / $506.78 / $570.58	Professional		$355.59	$506.78	$570.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $296.43 / $482.00 / $646.07	Facility		$296.43	$482.00	$646.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $330.91 / $433.18 / $464.31	Facility		$330.91	$433.18	$464.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $296.43 / $549.46 / $637.32	Facility		$296.43	$549.46	$637.32
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $88.01 / $88.01 / $88.01	Facility	80	$88.01	$88.01	$88.01
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $74.81 / $74.81 / $74.81	Facility	AS	$74.81	$74.81	$74.81
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