Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,861.12 / $2,861.12 / $2,861.12	Facility		$2,861.12	$2,861.12	$2,861.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,623.86 / $2,623.86 / $2,861.12	Professional		$2,623.86	$2,623.86	$2,861.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,349.85 / $3,349.85 / $3,349.85	Facility		$3,349.85	$3,349.85	$3,349.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $356.67 / $2,847.37 / $3,349.85	Professional		$356.67	$2,847.37	$3,349.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $420.75 / $2,861.12 / $3,807.80	Facility		$420.75	$2,861.12	$3,807.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $330.72 / $399.82 / $453.81	Professional		$330.72	$399.82	$453.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,022.24 / $4,022.24 / $79,999.20	Facility		$4,022.24	$4,022.24	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,022.24 / $4,022.24 / $4,022.24	Professional		$4,022.24	$4,022.24	$4,022.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $304.62 / $3,025.40 / $5,566.00	Facility		$304.62	$3,025.40	$5,566.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $356.67 / $501.68 / $3,349.85	Professional		$356.67	$501.68	$3,349.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,741.32 / $1,741.32 / $3,344.53	Professional		$1,741.32	$1,741.32	$3,344.53