Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.80 / $64.80 / $64.80	Facility		$64.80	$64.80	$64.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.80 / $64.80 / $111.21	Professional		$64.80	$64.80	$111.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.45 / $89.45 / $89.45	Facility		$89.45	$89.45	$89.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $27.79 / $27.79	Professional		$27.79	$27.79	$27.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $64.80 / $64.80 / $103.03	Facility		$64.80	$64.80	$103.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $59,999.40 / $59,999.40	Professional		$80.00	$59,999.40	$59,999.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $24.71 / $37.42 / $41.18	Facility		$24.71	$37.42	$41.18
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $21.01 / $21.01 / $21.01	Professional		$21.01	$21.01	$21.01
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.80 / $64.80 / $103.03	Facility		$64.80	$64.80	$103.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $1,800,000.00 / $2,400,000.00	Professional		$27.79	$1,800,000.00	$2,400,000.00