Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Facility		$150.00	$150.00	$150.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $124.50 / $150.00	Professional		$120.00	$124.50	$150.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $255.00 / $255.00	Facility		$127.50	$255.00	$255.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
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 $124.50 / $150.00 / $194.16	Facility		$124.50	$150.00	$194.16
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 $124.50 / $150.00 / $267.68	Facility		$124.50	$150.00	$267.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $2,400,000.00	Professional		$127.50	$127.50	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $172.50	Professional		$150.00	$150.00	$172.50