Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $650.79 / $2,903.00 / $9,367.19	Facility		$650.79	$2,903.00	$9,367.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $467.64 / $663.19 / $754.95	Professional		$467.64	$663.19	$754.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $287.60 / $662.70 / $1,031.18	Facility		$287.60	$662.70	$1,031.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $492.25 / $599.65 / $831.47	Facility		$492.25	$599.65	$831.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $287.60 / $756.61 / $1,031.18	Facility		$287.60	$756.61	$1,031.18
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $734.75 / $734.75 / $734.75	Facility	80	$734.75	$734.75	$734.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,078.00 / $36,056.00 / $61,876.00	Facility		$1,078.00	$36,056.00	$61,876.00