Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $450.00 / $450.00	Facility		$45.00	$450.00	$450.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.00 / $450.00 / $495.00	Professional		$450.00	$450.00	$495.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.52 / $258.52 / $258.52	Professional		$258.52	$258.52	$258.52
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 $450.00 / $450.00 / $967.50	Facility		$450.00	$450.00	$967.50
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 $450.00 / $450.00 / $967.50	Facility		$450.00	$450.00	$967.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $258.52 / $2,250,000.00 / $2,400,000.00	Professional		$258.52	$2,250,000.00	$2,400,000.00