Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility		$1,819.70	$1,819.70	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,819.70 / $2,089.30	Professional		$1,778.28	$1,819.70	$2,089.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,949.84 / $3,311.31	Facility		$1,737.80	$1,949.84	$3,311.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,819.70 / $2,041.74	Professional		$1,778.28	$1,819.70	$2,041.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,089.30	Facility		$2,041.74	$2,041.74	$2,089.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,862.09 / $2,754.23	Facility		$1,659.59	$1,862.09	$2,754.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $79.43	Professional		$70.79	$79.43	$79.43