Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $128.82	Professional		$120.23	$120.23	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $151.36	Professional		$79.43	$95.50	$151.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $125.89	Facility		$120.23	$120.23	$125.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $120.23 / $2,691,534.80	Facility		$95.50	$120.23	$2,691,534.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $87.10	Professional		$79.43	$79.43	$87.10