Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,423.75 / $2,463.09 / $3,374.29	Facility		$1,423.75	$2,463.09	$3,374.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,356.75 / $1,423.75 / $1,668.30	Professional		$1,356.75	$1,423.75	$1,668.30
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,361.69 / $8,883.66 / $8,883.66	Facility		$2,361.69	$8,883.66	$8,883.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,127.50 / $10,274.74 / $14,610.30	Professional		$1,127.50	$10,274.74	$14,610.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.10 / $1,380.10 / $2,760.20	Facility		$1,380.10	$1,380.10	$2,760.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.10 / $1,380.10 / $1,380.10	Professional		$1,380.10	$1,380.10	$1,380.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $510.97 / $1,075.61 / $4,103.39	Facility		$510.97	$1,075.61	$4,103.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $510.97 / $1,075.61 / $4,103.39	Professional		$510.97	$1,075.61	$4,103.39
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 $1,610.40 / $1,610.40 / $3,053.36	Facility		$1,610.40	$1,610.40	$3,053.36
United Facility/Professional Professional Modifier Low / Median / High Price $1,675.00 / $1,675.00 / $2,010.00	Professional		$1,675.00	$1,675.00	$2,010.00