Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.72 / $187.77 / $262.64	Facility		$82.72	$187.77	$262.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.25 / $82.72 / $137.36	Professional		$55.25	$82.72	$137.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $37.33 / $137.41 / $516.83	Facility		$37.33	$137.41	$516.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $90.55 / $633.60 / $849.98	Professional		$90.55	$633.60	$849.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.29 / $80.29 / $160.58	Facility		$80.29	$80.29	$160.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.29 / $80.29 / $80.29	Professional		$80.29	$80.29	$80.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $103.85 / $237.45 / $294.20	Facility		$103.85	$237.45	$294.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.85 / $237.45 / $300.39	Professional		$103.85	$237.45	$300.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $65.00	Professional		$50.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.47 / $192.90 / $195.64	Facility		$128.47	$192.90	$195.64
United Facility/Professional Professional Modifier Low / Median / High Price $42.15 / $98.95 / $107.12	Professional		$42.15	$98.95	$107.12