Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $15.00 / $15.00	Professional		$15.00	$15.00	$15.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.68 / $1.68 / $1.68	Professional		$1.68	$1.68	$1.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $170.00 / $178.00	Professional		$170.00	$170.00	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $15.00 / $27.60	Facility		$15.00	$15.00	$27.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $15.00 / $32.25	Facility		$15.00	$15.00	$32.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $1.68 / $2,250,000.00 / $2,400,000.00	Professional		$1.68	$2,250,000.00	$2,400,000.00