Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $500.00 / $500.00	Facility		$500.00	$500.00	$500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $915.68 / $915.68	Professional		$500.00	$915.68	$915.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $872.08 / $1,744.16 / $1,744.16	Facility		$872.08	$1,744.16	$1,744.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $872.08 / $872.08 / $987.26	Professional		$872.08	$872.08	$987.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $175.00 / $194.25	Professional		$150.00	$175.00	$194.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $494.68 / $872.08 / $1,254.48	Facility		$494.68	$872.08	$1,254.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $337.08 / $358.06 / $358.06	Professional		$337.08	$358.06	$358.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $872.08 / $872.08 / $79,999.20	Facility		$872.08	$872.08	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $494.68 / $872.08 / $1,968.71	Facility		$494.68	$872.08	$1,968.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $872.08 / $1,028.40 / $2,400,000.00	Professional		$872.08	$1,028.40	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $872.08 / $872.08 / $1,002.89	Professional		$872.08	$872.08	$1,002.89