Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Professional		$5.00	$5.00	$5.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.55 / $22.55 / $22.55	Facility		$22.55	$22.55	$22.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $19.17 / $22.55	Professional		$19.17	$19.17	$22.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $6.85	Facility		$5.00	$5.00	$6.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.25 / $120.25 / $79,999.20	Facility		$120.25	$120.25	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $120.25 / $120.25 / $120.25	Professional		$120.25	$120.25	$120.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $2,700,000.00	Facility		$5.00	$5.00	$2,700,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $22.55 / $2,400,000.00	Professional		$19.17	$22.55	$2,400,000.00