Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.02 / $2.02 / $2.02	Facility		$2.02	$2.02	$2.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.02 / $2.02 / $2.02	Professional		$2.02	$2.02	$2.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.87 / $93.87 / $93.87	Professional		$93.87	$93.87	$93.87
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 $2.02 / $2.02 / $4.36	Facility		$2.02	$2.02	$4.36
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 $2.02 / $2.02 / $4.36	Facility		$2.02	$2.02	$4.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.87 / $2,250,000.00 / $2,400,000.00	Professional		$93.87	$2,250,000.00	$2,400,000.00