Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $412.80 / $553.20	Facility		$50.50	$412.80	$553.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $50.50 / $694.32	Professional		$38.00	$50.50	$694.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $2,880.00 / $4,512.00	Professional		$200.00	$2,880.00	$4,512.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.00 / $347.50 / $458.85	Professional		$270.00	$347.50	$458.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $227.91 / $227.91 / $227.91	Professional		$227.91	$227.91	$227.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $234.00 / $312.00 / $414.00	Facility		$234.00	$312.00	$414.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $201.60 / $201.60 / $201.60	Professional		$201.60	$201.60	$201.60