Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.67 / $190.67 / $190.67	Facility		$190.67	$190.67	$190.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.67 / $256.80 / $256.80	Professional		$190.67	$256.80	$256.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.57 / $40.57 / $40.57	Professional		$40.57	$40.57	$40.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $43.48 / $49.85 / $367.22	Facility		$43.48	$49.85	$367.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $37.54 / $47.37 / $49.28	Professional		$37.54	$47.37	$49.28
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 $43.48 / $54.84 / $2,526.53	Facility		$43.48	$54.84	$2,526.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $49.12 / $56.48	Professional		$40.15	$49.12	$56.48
United Facility/Professional Professional Modifier Low / Median / High Price $24.32 / $25.54 / $274.54	Professional		$24.32	$25.54	$274.54