Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.86 / $2.86 / $2.86	Facility		$2.86	$2.86	$2.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.86 / $4.04 / $4.75	Professional		$2.86	$4.04	$4.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2.98 / $2.98 / $2.98	Professional		$2.98	$2.98	$2.98
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 $4.04 / $4.04 / $8.69	Facility		$4.04	$4.04	$8.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2.85 / $2.85 / $79,999.20	Facility		$2.85	$2.85	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2.85 / $2.85 / $2.85	Professional		$2.85	$2.85	$2.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $4.04 / $4.24 / $8.69	Facility		$4.04	$4.24	$8.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $2.98 / $2,250,000.00 / $2,400,000.00	Professional		$2.98	$2,250,000.00	$2,400,000.00