Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Facility		$42.13	$42.13	$42.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.28 / $36.34 / $42.13	Professional		$35.28	$36.34	$42.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.86 / $14.86 / $14.86	Professional		$14.86	$14.86	$14.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.49 / $33.70 / $91.17	Professional		$29.49	$33.70	$91.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $36.34 / $42.13 / $3,261.07	Facility		$36.34	$42.13	$3,261.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $43.39 / $79,999.20	Facility		$42.13	$43.39	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.34 / $42.13 / $3,261.07	Facility		$36.34	$42.13	$3,261.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.86 / $2,250,000.00 / $2,400,000.00	Professional		$14.86	$2,250,000.00	$2,400,000.00