Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $735.25 / $1,007.25	Facility		$425.00	$735.25	$1,007.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $405.00 / $425.00 / $498.00	Professional		$405.00	$425.00	$498.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $724.76 / $956.25 / $2,785.98	Facility		$724.76	$956.25	$2,785.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $388.00 / $3,061.82 / $4,354.88	Professional		$388.00	$3,061.82	$4,354.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $432.81 / $432.81 / $822.72	Facility		$432.81	$432.81	$822.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.81 / $432.81 / $432.81	Professional		$432.81	$432.81	$432.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $89.59 / $179.57 / $1,402.30	Facility		$89.59	$179.57	$1,402.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.22 / $211.01 / $1,402.30	Professional		$108.22	$211.01	$1,402.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $641.25 / $1,187.50	Professional		$475.00	$641.25	$1,187.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $658.24 / $957.56 / $1,002.32	Facility		$658.24	$957.56	$1,002.32
United Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $500.00 / $500.00	Professional		$500.00	$500.00	$500.00