Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1.26 / $1.26 / $1.26	Facility		$1.26	$1.26	$1.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1.26 / $1.26 / $1.26	Professional		$1.26	$1.26	$1.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.26 / $191.26 / $191.26	Professional		$191.26	$191.26	$191.26
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 $1.26 / $1.26 / $2.71	Facility		$1.26	$1.26	$2.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $368.58 / $368.58 / $79,999.20	Facility		$368.58	$368.58	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $368.58 / $368.58 / $368.58	Professional		$368.58	$368.58	$368.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $1.26 / $1.26 / $2.71	Facility		$1.26	$1.26	$2.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $191.26 / $191.26 / $2,400,000.00	Professional		$191.26	$191.26	$2,400,000.00