Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.25 / $49.94 / $54.97	Professional		$37.25	$49.94	$54.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.71 / $105.73 / $119.04	Professional		$84.71	$105.73	$119.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $49.94 / $77.88 / $128.65	Facility		$49.94	$77.88	$128.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.22 / $17,150.38 / $18,772.80	Professional		$107.22	$17,150.38	$18,772.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $55.88 / $84.31 / $93.13	Facility		$55.88	$84.31	$93.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $49.94 / $103.95 / $130.90	Facility		$49.94	$103.95	$130.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $105.22 / $2,250,000.00 / $2,400,000.00	Professional		$105.22	$2,250,000.00	$2,400,000.00