Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.87 / $91.87 / $91.87	Facility		$91.87	$91.87	$91.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.13 / $68.13 / $88.72	Professional		$68.13	$68.13	$88.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.29 / $35.29 / $35.29	Professional		$35.29	$35.29	$35.29
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $68.13 / $71.54 / $93.34	Facility		$68.13	$71.54	$93.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.43 / $1,071.43 / $79,999.20	Facility		$1,071.43	$1,071.43	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,071.43 / $1,071.43 / $1,071.43	Professional		$1,071.43	$1,071.43	$1,071.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.13 / $68.13 / $97.43	Facility		$68.13	$68.13	$97.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.29 / $2,250,000.00 / $2,400,000.00	Professional		$35.29	$2,250,000.00	$2,400,000.00