Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,759.04 / $2,759.04 / $2,759.04	Facility		$2,759.04	$2,759.04	$2,759.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,529.84 / $2,529.84 / $2,759.04	Professional		$2,529.84	$2,529.84	$2,759.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,673.00 / $2,673.00 / $2,673.00	Facility		$2,673.00	$2,673.00	$2,673.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $343.88 / $2,272.05 / $2,673.00	Professional		$343.88	$2,272.05	$2,673.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $413.23 / $2,759.04 / $3,671.90	Facility		$413.23	$2,759.04	$3,671.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $318.86 / $385.55 / $437.54	Professional		$318.86	$385.55	$437.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,878.51 / $3,878.51 / $79,999.20	Facility		$3,878.51	$3,878.51	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,878.51 / $3,878.51 / $3,878.51	Professional		$3,878.51	$3,878.51	$3,878.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $293.75 / $2,759.04 / $5,368.00	Facility		$293.75	$2,759.04	$5,368.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $343.88 / $483.71 / $2,673.00	Professional		$343.88	$483.71	$2,673.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,678.96 / $1,678.96 / $3,224.73	Professional		$1,678.96	$1,678.96	$3,224.73