Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $48.75 / $122.46	Professional		$48.75	$48.75	$122.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.65 / $592.14 / $751.00	Professional		$75.65	$592.14	$751.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $48.75 / $48.75 / $104.81	Facility		$48.75	$48.75	$104.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,617.99 / $3,762.71 / $3,824.53	Facility		$3,617.99	$3,762.71	$3,824.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $48.75 / $48.75 / $104.81	Facility		$48.75	$48.75	$104.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.65 / $75.65 / $75.65	Professional		$75.65	$75.65	$75.65
United Facility/Professional Professional Modifier Low / Median / High Price $395.78 / $395.78 / $395.78	Professional		$395.78	$395.78	$395.78