Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1.69 / $1.69 / $1.69	Facility		$1.69	$1.69	$1.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1.69 / $1.69 / $2.80	Professional		$1.69	$1.69	$2.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.89 / $1.89 / $1.89	Professional		$1.89	$1.89	$1.89
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 $1.69 / $1.69 / $3.63	Facility		$1.69	$1.69	$3.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $7.35 / $7.35 / $79,999.20	Facility		$7.35	$7.35	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $7.35 / $7.35 / $7.35	Professional		$7.35	$7.35	$7.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $1.69 / $1.77 / $3.63	Facility		$1.69	$1.77	$3.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $1.89 / $2,250,000.00 / $2,400,000.00	Professional		$1.89	$2,250,000.00	$2,400,000.00