Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,936.64 / $2,936.64 / $2,936.64	Facility		$2,936.64	$2,936.64	$2,936.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,791.08 / $2,791.08 / $2,936.64	Professional		$2,791.08	$2,791.08	$2,936.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,621.85 / $3,621.85 / $3,621.85	Facility		$3,621.85	$3,621.85	$3,621.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $386.96 / $3,078.57 / $3,621.85	Professional		$386.96	$3,078.57	$3,621.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $431.86 / $2,936.64 / $3,908.30	Facility		$431.86	$2,936.64	$3,908.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $358.81 / $410.37 / $492.35	Professional		$358.81	$410.37	$492.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,128.24 / $4,128.24 / $79,999.20	Facility		$4,128.24	$4,128.24	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,128.24 / $4,128.24 / $4,128.24	Professional		$4,128.24	$4,128.24	$4,128.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $312.66 / $3,282.33 / $5,713.00	Facility		$312.66	$3,282.33	$5,713.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $386.96 / $533.70 / $3,621.85	Professional		$386.96	$533.70	$3,621.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,852.20 / $1,852.20 / $3,704.40	Professional		$1,852.20	$1,852.20	$3,704.40