Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Facility		$25.00	$25.00	$25.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.66 / $5.66 / $101.20	Professional		$5.66	$5.66	$101.20
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 $5.66 / $5.66 / $12.17	Facility		$5.66	$5.66	$12.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $5.66 / $5.66 / $12.17	Facility		$5.66	$5.66	$12.17
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