Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.89 / $326.62 / $731.34	Facility		$108.89	$326.62	$731.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.31 / $110.17 / $710.40	Professional		$106.31	$110.17	$710.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.00 / $141.00 / $262.39	Professional		$141.00	$141.00	$262.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $225.27 / $245.00 / $638.99	Facility		$225.27	$245.00	$638.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $81.09 / $739.96 / $992.63	Professional		$81.09	$739.96	$992.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.99 / $109.99 / $198.54	Facility		$109.99	$109.99	$198.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $109.99 / $109.99	Professional		$109.99	$109.99	$109.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $113.46 / $267.27 / $328.19	Facility		$113.46	$267.27	$328.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.46 / $267.27 / $353.29	Professional		$113.46	$267.27	$353.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $133.73	Professional		$75.00	$75.00	$133.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $137.08 / $228.47 / $228.47	Facility		$137.08	$228.47	$228.47
United Facility/Professional Professional Modifier Low / Median / High Price $450.58 / $450.58 / $540.70	Professional		$450.58	$450.58	$540.70