Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Facility		$20.00	$20.00	$20.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $28.91 / $28.91	Professional		$28.91	$28.91	$28.91
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 $20.00 / $20.00 / $43.00	Facility		$20.00	$20.00	$43.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $137.63 / $137.63 / $79,999.20	Facility		$137.63	$137.63	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $137.63 / $137.63 / $137.63	Professional		$137.63	$137.63	$137.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $20.00 / $43.00	Facility		$20.00	$20.00	$43.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $2,250,000.00 / $2,400,000.00	Professional		$28.91	$2,250,000.00	$2,400,000.00