Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.72 / $129.27 / $177.09	Facility		$74.72	$129.27	$177.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.20 / $74.72 / $75.59	Professional		$71.20	$74.72	$75.59
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $358.70 / $1,378.85 / $1,378.85	Facility		$358.70	$1,378.85	$1,378.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,337.71 / $1,337.71 / $1,935.83	Professional		$1,337.71	$1,337.71	$1,935.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.94 / $136.94 / $344.82	Facility		$136.94	$136.94	$344.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $136.94 / $136.94	Professional		$136.94	$136.94	$136.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $79.67 / $187.98 / $230.45	Facility		$79.67	$187.98	$230.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.67 / $187.01 / $232.50	Professional		$79.67	$187.01	$232.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $97.86	Professional		$75.00	$75.00	$97.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $84.52 / $84.52 / $302.95	Facility		$84.52	$84.52	$302.95
United Facility/Professional Professional Modifier Low / Median / High Price $83.51 / $83.51 / $100.21	Professional		$83.51	$83.51	$100.21