Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Facility		$75.00	$75.00	$75.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $98.27 / $98.27	Professional		$98.27	$98.27	$98.27
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 $75.00 / $75.00 / $161.25	Facility		$75.00	$75.00	$161.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.43 / $147.43 / $79,999.20	Facility		$147.43	$147.43	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $147.43 / $147.43 / $147.43	Professional		$147.43	$147.43	$147.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $161.25	Facility		$75.00	$75.00	$161.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $2,250,000.00 / $2,400,000.00	Professional		$98.27	$2,250,000.00	$2,400,000.00