Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.55 / $176.55 / $353.10	Facility		$176.55	$176.55	$353.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.54 / $146.54 / $176.55	Professional		$146.54	$146.54	$176.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $146.54 / $209.55 / $315.06	Facility		$146.54	$209.55	$315.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $187.14 / $13,910.16 / $18,772.80	Professional		$187.14	$13,910.16	$18,772.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $149.71 / $149.71 / $79,999.20	Facility		$149.71	$149.71	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $146.54 / $209.55 / $2,400,000.00	Facility		$146.54	$209.55	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $136.80 / $136.80 / $157.32	Professional		$136.80	$136.80	$157.32