Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.34 / $108.34 / $108.34	Facility		$108.34	$108.34	$108.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.18 / $167.28 / $192.92	Professional		$115.18	$167.28	$192.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.99 / $303.29 / $363.38	Professional		$288.99	$303.29	$363.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $170.00 / $178.00	Professional		$170.00	$170.00	$178.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $154.53 / $192.92 / $400.76	Facility		$154.53	$192.92	$400.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $31.08 / $17,150.38 / $18,772.80	Professional		$31.08	$17,150.38	$18,772.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $31.08 / $31.08 / $79,999.20	Facility		$31.08	$31.08	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $154.53 / $192.92 / $2,400,000.00	Facility		$154.53	$192.92	$2,400,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,250,000.00 / $2,250,000.00 / $2,400,000.00	Professional		$2,250,000.00	$2,250,000.00	$2,400,000.00