Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,190.00 / $2,058.69 / $2,820.30	Facility		$1,190.00	$2,058.69	$2,820.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,134.00 / $1,190.00 / $1,394.40	Professional		$1,134.00	$1,190.00	$1,394.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,190.00 / $4,242.67 / $4,242.67	Facility		$1,190.00	$4,242.67	$4,242.67
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $538.48 / $4,908.43 / $6,977.63	Professional		$538.48	$4,908.43	$6,977.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $659.12 / $659.12 / $1,318.24	Facility		$659.12	$659.12	$1,318.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $659.12 / $659.12 / $659.12	Professional		$659.12	$659.12	$659.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $244.03 / $513.77 / $1,960.14	Facility		$244.03	$513.77	$1,960.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $244.03 / $513.77 / $1,960.14	Professional		$244.03	$513.77	$1,960.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $890.59	Professional		$75.00	$75.00	$890.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $769.15 / $769.15 / $1,458.24	Facility		$769.15	$769.15	$1,458.24
United Facility/Professional Professional Modifier Low / Median / High Price $1,400.00 / $1,400.00 / $1,680.00	Professional		$1,400.00	$1,400.00	$1,680.00