Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.81 / $2,747.00 / $7,920.26	Facility		$74.81	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $152.27 / $180.59 / $213.98	Professional		$152.27	$180.59	$213.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $109.00 / $157.97 / $210.80	Facility		$109.00	$157.97	$210.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $122.58 / $162.52 / $170.68	Facility		$122.58	$162.52	$170.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.00 / $166.29 / $217.10	Facility		$109.00	$166.29	$217.10
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $27.41 / $27.41 / $27.41	Facility	AS	$27.41	$27.41	$27.41
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