Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $339.78 / $339.78 / $378.80	Facility		$339.78	$339.78	$378.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.29 / $346.93 / $394.93	Professional		$245.29	$346.93	$394.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $199.39 / $308.72 / $428.88	Facility		$199.39	$308.72	$428.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $228.68 / $298.80 / $320.27	Facility		$228.68	$298.80	$320.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $199.39 / $329.76 / $428.69	Facility		$199.39	$329.76	$428.69
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $4,113.00 / $6,216.00	Facility		$376.00	$4,113.00	$6,216.00