Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,007.68 / $4,007.68 / $4,007.68	Facility		$4,007.68	$4,007.68	$4,007.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,007.68 / $5,321.94 / $5,321.94	Professional		$4,007.68	$5,321.94	$5,321.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,539.60 / $6,539.60 / $6,539.60	Facility		$6,539.60	$6,539.60	$6,539.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $752.44 / $5,558.66 / $6,539.60	Professional		$752.44	$5,558.66	$6,539.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $574.14 / $5,588.04 / $7,291.06	Facility		$574.14	$5,588.04	$7,291.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $560.04 / $1,011.40 / $1,064.63	Professional		$560.04	$1,011.40	$1,064.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $6,001.96 / $6,001.96 / $79,999.20	Facility		$6,001.96	$6,001.96	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $6,001.96 / $6,001.96 / $6,001.96	Professional		$6,001.96	$6,001.96	$6,001.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $426.70 / $6,220.65 / $7,797.00	Facility		$426.70	$6,220.65	$7,797.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $857.60 / $1,013.33 / $6,539.60	Professional		$857.60	$1,013.33	$6,539.60
United Facility/Professional Professional Modifier Low / Median / High Price $2,864.04 / $3,009.76 / $5,891.53	Professional		$2,864.04	$3,009.76	$5,891.53