Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.00 / $32.00 / $32.00	Facility		$32.00	$32.00	$32.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $32.00 / $32.00	Professional		$32.00	$32.00	$32.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.20 / $17.20 / $17.20	Professional		$17.20	$17.20	$17.20
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 $32.00 / $32.00 / $68.80	Facility		$32.00	$32.00	$68.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4.20 / $4.20 / $79,999.20	Facility		$4.20	$4.20	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4.20 / $4.20 / $4.20	Professional		$4.20	$4.20	$4.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.00 / $32.00 / $68.80	Facility		$32.00	$32.00	$68.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.20 / $17.20 / $2,400,000.00	Professional		$17.20	$17.20	$2,400,000.00