Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.00 / $2.04 / $2.04	Facility		$2.00	$2.04	$2.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Professional		$2.00	$2.00	$2.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $173.78 / $208.93	Professional		$151.36	$173.78	$208.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $2.04 / $2.04 / $3.09	Facility		$2.04	$2.04	$3.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Professional		$2.00	$2.00	$2.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $2.04 / $2.04 / $3.16	Facility		$2.04	$2.04	$3.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $93.33	Professional		$79.43	$93.33	$93.33