Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $55.00	Facility		$55.00	$55.00	$55.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $28.36 / $55.00	Professional		$28.36	$28.36	$55.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.60 / $12.60 / $12.60	Facility		$12.60	$12.60	$12.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $10.71 / $12.60	Professional		$10.71	$10.71	$12.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.36 / $29.78 / $50.00	Facility		$28.36	$29.78	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $20.61 / $20.61 / $79,999.20	Facility		$20.61	$20.61	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.36 / $28.36 / $50.00	Facility		$28.36	$28.36	$50.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $2,250,000.00 / $2,400,000.00	Professional		$10.71	$2,250,000.00	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $13.25 / $13.25 / $22.08	Professional		$13.25	$13.25	$22.08