Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,201.78 / $5,116.62 / $20,400.00	Facility		$1,201.78	$5,116.62	$20,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,201.78 / $1,201.78 / $1,507.37	Professional		$1,201.78	$1,201.78	$1,507.37
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,201.78 / $1,201.78 / $2,583.83	Facility		$1,201.78	$1,201.78	$2,583.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,755.69 / $1,755.69 / $1,755.69	Professional		$1,755.69	$1,755.69	$1,755.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,201.78 / $1,453.55 / $2,583.83	Facility		$1,201.78	$1,453.55	$2,583.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,800,000.00 / $2,400,000.00 / $2,400,000.00	Professional		$1,800,000.00	$2,400,000.00	$2,400,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $676.00 / $4,113.00 / $6,216.00	Facility		$676.00	$4,113.00	$6,216.00