Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $370.95 / $370.95 / $413.38	Facility		$370.95	$370.95	$413.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $268.04 / $379.07 / $431.53	Professional		$268.04	$379.07	$431.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $218.06 / $337.35 / $469.59	Facility		$218.06	$337.35	$469.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $249.52 / $326.52 / $350.88	Facility		$249.52	$326.52	$350.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $218.06 / $359.78 / $468.83	Facility		$218.06	$359.78	$468.83
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