Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.00 / $128.00 / $128.00	Facility		$128.00	$128.00	$128.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $119.70 / $128.00	Professional		$119.70	$119.70	$128.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.50 / $94.50 / $94.50	Facility		$94.50	$94.50	$94.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $94.50 / $150.55	Professional		$80.33	$94.50	$150.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $119.70 / $119.70 / $163.99	Facility		$119.70	$119.70	$163.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $190.74 / $190.74 / $79,999.20	Facility		$190.74	$190.74	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $190.74 / $190.74 / $190.74	Professional		$190.74	$190.74	$190.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $94.50 / $119.70 / $2,700,000.00	Facility		$94.50	$119.70	$2,700,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $150.55 / $2,400,000.00	Professional		$80.33	$150.55	$2,400,000.00