Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.24 / $182.24 / $182.24	Facility		$182.24	$182.24	$182.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.52 / $182.24 / $182.24	Professional		$171.52	$182.24	$182.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $192.96 / $804.00 / $804.00	Facility		$192.96	$804.00	$804.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $814.72 / $814.72 / $964.80	Professional		$814.72	$814.72	$964.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.24 / $182.24 / $728.96	Facility		$182.24	$182.24	$728.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.24 / $182.24 / $182.24	Professional		$182.24	$182.24	$182.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $192.96 / $192.96 / $192.96	Professional		$192.96	$192.96	$192.96