Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $575.44	Facility		$562.34	$562.34	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $575.44 / $758.58	Professional		$562.34	$575.44	$758.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $954.99	Facility		$575.44	$575.44	$954.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $575.44 / $758.58	Professional		$562.34	$575.44	$758.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $954.99	Facility		$575.44	$575.44	$954.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $100.00	Professional		$79.43	$79.43	$100.00