Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.00 / $4.00 / $4.00	Facility		$4.00	$4.00	$4.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $4.00 / $4.00	Professional		$4.00	$4.00	$4.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.76 / $1.76 / $1.76	Professional		$1.76	$1.76	$1.76
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 $4.00 / $4.00 / $8.60	Facility		$4.00	$4.00	$8.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $9.78 / $9.78 / $79,999.20	Facility		$9.78	$9.78	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $9.78 / $9.78 / $9.78	Professional		$9.78	$9.78	$9.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $4.00 / $4.00 / $8.60	Facility		$4.00	$4.00	$8.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $1.76 / $2,250,000.00 / $2,400,000.00	Professional		$1.76	$2,250,000.00	$2,400,000.00