Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.00 / $4.00 / $4.00	Facility		$4.00	$4.00	$4.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $4.00 / $4.00	Professional		$4.00	$4.00	$4.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.33 / $1.33 / $1.33	Professional		$1.33	$1.33	$1.33
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 $4.00 / $4.00 / $8.60	Facility		$4.00	$4.00	$8.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $13,910.16 / $17,150.38 / $18,772.80	Professional		$13,910.16	$17,150.38	$18,772.80
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 $4.00 / $4.00 / $8.60	Facility		$4.00	$4.00	$8.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $1.33 / $2,250,000.00 / $2,400,000.00	Professional		$1.33	$2,250,000.00	$2,400,000.00