Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,293.04 / $3,293.04 / $3,293.04	Facility		$3,293.04	$3,293.04	$3,293.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,163.26 / $3,163.26 / $3,293.04	Professional		$3,163.26	$3,163.26	$3,293.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,124.25 / $4,124.25 / $4,124.25	Facility		$4,124.25	$4,124.25	$4,124.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.07 / $3,505.61 / $4,124.25	Professional		$441.07	$3,505.61	$4,124.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $484.27 / $3,321.42 / $4,382.60	Facility		$484.27	$3,321.42	$4,382.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $408.98 / $460.17 / $561.19	Professional		$408.98	$460.17	$561.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,629.09 / $4,629.09 / $79,999.20	Facility		$4,629.09	$4,629.09	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,629.09 / $4,629.09 / $4,629.09	Professional		$4,629.09	$4,629.09	$4,629.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $350.61 / $3,741.27 / $6,407.00	Facility		$350.61	$3,741.27	$6,407.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $441.07 / $604.88 / $4,124.25	Professional		$441.07	$604.88	$4,124.25
United Facility/Professional Professional Modifier Low / Median / High Price $2,099.16 / $2,099.16 / $4,032.53	Professional		$2,099.16	$2,099.16	$4,032.53