Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.24 / $163.24 / $163.24	Facility		$163.24	$163.24	$163.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.24 / $163.24 / $179.56	Professional		$163.24	$163.24	$179.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $172.75 / $492.01 / $492.01	Facility		$172.75	$492.01	$492.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $192.05 / $192.05 / $290.39	Professional		$192.05	$192.05	$290.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $179.39 / $179.39 / $717.56	Facility		$179.39	$179.39	$717.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.39 / $179.39 / $179.39	Professional		$179.39	$179.39	$179.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $50.00 / $50.00	Professional		$30.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $178.75 / $214.70 / $217.75	Facility		$178.75	$214.70	$217.75
United Facility/Professional Professional Modifier Low / Median / High Price $164.98 / $186.43 / $197.98	Professional		$164.98	$186.43	$197.98