Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.22 / $24.22 / $56.98	Facility		$24.22	$24.22	$56.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.79 / $23.65 / $28.49	Professional		$22.79	$23.65	$28.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4.04 / $4.04 / $4.04	Professional		$4.04	$4.04	$4.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $175.00 / $194.25	Professional		$150.00	$175.00	$194.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $23.65 / $28.38 / $36.88	Facility		$23.65	$28.38	$36.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $9.19 / $9.19 / $79,999.20	Facility		$9.19	$9.19	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.65 / $28.49 / $50.85	Facility		$23.65	$28.49	$50.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $4.04 / $28.81 / $2,250,000.00	Professional		$4.04	$28.81	$2,250,000.00