Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.50 / $1,718.81 / $1,718.81	Facility		$187.50	$1,718.81	$1,718.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $37.20 / $100.00 / $100.00	Facility		$37.20	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $108.50 / $124.00	Professional		$75.00	$108.50	$124.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $967.96 / $967.96 / $967.96	Professional		$967.96	$967.96	$967.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1.20 / $1.20 / $1.20	Facility		$1.20	$1.20	$1.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1.20 / $1.20 / $1.20	Professional		$1.20	$1.20	$1.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $76.50 / $93.50	Professional		$60.00	$76.50	$93.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.43 / $1,071.43 / $1,071.43	Facility		$1,071.43	$1,071.43	$1,071.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,071.43 / $1,071.43 / $1,071.43	Professional		$1,071.43	$1,071.43	$1,071.43