Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,263.12 / $4,263.12 / $4,263.12	Facility		$4,263.12	$4,263.12	$4,263.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,165.02 / $4,165.02 / $4,263.12	Professional		$4,165.02	$4,165.02	$4,263.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,470.13 / $5,470.13 / $5,470.13	Facility		$5,470.13	$5,470.13	$5,470.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $585.88 / $4,649.60 / $5,470.13	Professional		$585.88	$4,649.60	$5,470.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $626.92 / $4,373.27 / $5,706.08	Facility		$626.92	$4,373.27	$5,706.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $543.26 / $595.74 / $745.45	Professional		$543.26	$595.74	$745.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,992.99 / $5,992.99 / $79,999.20	Facility		$5,992.99	$5,992.99	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,992.99 / $5,992.99 / $5,992.99	Professional		$5,992.99	$5,992.99	$5,992.99
Providence Facility/Professional Facility Modifier Low / Median / High Price $453.90 / $4,969.67 / $11,318.19	Facility		$453.90	$4,969.67	$11,318.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $585.88 / $796.48 / $5,470.13	Professional		$585.88	$796.48	$5,470.13
United Facility/Professional Professional Modifier Low / Median / High Price $2,763.88 / $2,763.88 / $5,309.87	Professional		$2,763.88	$2,763.88	$5,309.87