Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $987.52 / $987.52 / $987.52	Facility		$987.52	$987.52	$987.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $640.00 / $640.00 / $1,820.00	Professional		$640.00	$640.00	$1,820.00
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 $640.00 / $640.00 / $1,376.00	Facility		$640.00	$640.00	$1,376.00
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 $640.00 / $640.00 / $1,376.00	Facility		$640.00	$640.00	$1,376.00
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