Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.37 / $111.37 / $111.37	Professional		$111.37	$111.37	$111.37
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 $100.00 / $100.00 / $215.00	Facility		$100.00	$100.00	$215.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $122.86 / $122.86 / $79,999.20	Facility		$122.86	$122.86	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $122.86 / $122.86 / $122.86	Professional		$122.86	$122.86	$122.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $215.00	Facility		$100.00	$100.00	$215.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.37 / $2,250,000.00 / $2,400,000.00	Professional		$111.37	$2,250,000.00	$2,400,000.00