Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.05 / $17.05 / $17.05	Facility		$17.05	$17.05	$17.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.64 / $14.15 / $17.05	Professional		$13.64	$14.15	$17.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.05 / $34.10 / $34.10	Facility		$17.05	$34.10	$34.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $17.05 / $20.11	Professional		$17.05	$17.05	$20.11
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 $14.15 / $15.57 / $30.42	Facility		$14.15	$15.57	$30.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $27.62 / $79,999.20 / $79,999.20	Facility		$27.62	$79,999.20	$79,999.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $14.15 / $17.05 / $30.42	Facility		$14.15	$17.05	$30.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $20.11 / $2,400,000.00	Professional		$17.05	$20.11	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $17.05 / $20.46	Professional		$17.05	$17.05	$20.46