Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $110.70 / $602.34	Facility		$90.00	$110.70	$602.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $90.00 / $90.00	Professional		$90.00	$90.00	$90.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.80 / $90.80 / $90.80	Professional		$90.80	$90.80	$90.80
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 $90.00 / $90.00 / $193.50	Facility		$90.00	$90.00	$193.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.00 / $86.00 / $79,999.20	Facility		$86.00	$86.00	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $86.00 / $86.00	Professional		$86.00	$86.00	$86.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $193.50	Facility		$90.00	$90.00	$193.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $90.80 / $2,250,000.00 / $2,400,000.00	Professional		$90.80	$2,250,000.00	$2,400,000.00