Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Facility		$25.00	$25.00	$25.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.65 / $7.65 / $7.65	Professional		$7.65	$7.65	$7.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $34.25	Facility		$25.00	$25.00	$34.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4.18 / $4.18 / $79,999.20	Facility		$4.18	$4.18	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4.18 / $4.18 / $4.18	Professional		$4.18	$4.18	$4.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $35.75	Facility		$25.00	$25.00	$35.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $7.65 / $2,250,000.00 / $2,400,000.00	Professional		$7.65	$2,250,000.00	$2,400,000.00