Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $325.23 / $562.65 / $770.80	Facility		$325.23	$562.65	$770.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.17 / $325.23 / $575.28	Professional		$190.17	$325.23	$575.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $607.48 / $1,924.16 / $1,924.16	Facility		$607.48	$1,924.16	$1,924.16
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $676.80 / $2,621.34 / $3,758.10	Professional		$676.80	$2,621.34	$3,758.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $358.29 / $358.29 / $709.98	Facility		$358.29	$358.29	$709.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $358.29 / $358.29 / $358.29	Professional		$358.29	$358.29	$358.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $160.84 / $338.84 / $1,102.83	Facility		$160.84	$338.84	$1,102.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.84 / $338.84 / $1,102.83	Professional		$160.84	$338.84	$1,102.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $500.96	Professional		$75.00	$75.00	$500.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $432.65 / $432.65 / $792.69	Facility		$432.65	$432.65	$792.69
United Facility/Professional Professional Modifier Low / Median / High Price $676.80 / $676.80 / $812.16	Professional		$676.80	$676.80	$812.16