Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.67 / $52.67 / $52.67	Facility		$52.67	$52.67	$52.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $47.50 / $52.67	Professional		$47.50	$47.50	$52.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $29.52 / $29.52	Professional		$29.52	$29.52	$29.52
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 $50.00 / $77.50 / $114.14	Facility		$50.00	$77.50	$114.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $13,910.16 / $17,150.38 / $18,772.80	Professional		$13,910.16	$17,150.38	$18,772.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $79,999.20	Facility		$50.00	$50.00	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $77.50 / $2,400,000.00	Facility		$50.00	$77.50	$2,400,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $2,250,000.00 / $2,400,000.00	Professional		$29.52	$2,250,000.00	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.56 / $96.98 / $142.97	Professional		$69.56	$96.98	$142.97