Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.31 / $38.60 / $52.87	Facility		$22.31	$38.60	$52.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $22.31 / $26.15	Professional		$21.26	$22.31	$26.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.49 / $298.33 / $1,122.17	Facility		$50.49	$298.33	$1,122.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $360.00 / $1,375.72 / $1,845.60	Professional		$360.00	$1,375.72	$1,845.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.33 / $174.33 / $348.66	Facility		$174.33	$174.33	$348.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.33 / $174.33 / $174.33	Professional		$174.33	$174.33	$174.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $225.37 / $514.07 / $638.80	Facility		$225.37	$514.07	$638.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $225.37 / $514.07 / $651.90	Professional		$225.37	$514.07	$651.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $65.00	Professional		$45.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $278.95 / $418.83 / $424.78	Facility		$278.95	$418.83	$424.78
United Facility/Professional Professional Modifier Low / Median / High Price $136.19 / $214.84 / $231.91	Professional		$136.19	$214.84	$231.91