Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3.00 / $3.00 / $3.00	Facility		$3.00	$3.00	$3.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $3.00 / $3.00	Professional		$3.00	$3.00	$3.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $8.50 / $8.50	Professional		$8.50	$8.50	$8.50
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 $3.00 / $3.00 / $6.45	Facility		$3.00	$3.00	$6.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $22.31 / $22.31 / $79,999.20	Facility		$22.31	$22.31	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $22.31 / $22.31 / $22.31	Professional		$22.31	$22.31	$22.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $3.00 / $3.00 / $6.45	Facility		$3.00	$3.00	$6.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $2,250,000.00 / $2,400,000.00	Professional		$8.50	$2,250,000.00	$2,400,000.00