Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Professional		$630.96	$630.96	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Professional		$891.25	$891.25	$891.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Professional		$630.96	$630.96	$630.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,495.41 / $5,495.41 / $5,495.41	Facility		$5,495.41	$5,495.41	$5,495.41
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,495.41 / $5,495.41 / $5,495.41	Professional		$5,495.41	$5,495.41	$5,495.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $891.25 / $891.25	Professional		$79.43	$891.25	$891.25