Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.50 / $25.60 / $26.40	Professional		$13.50	$25.60	$26.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $7.20 / $100.00 / $100.00	Facility		$7.20	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $21.60 / $24.00	Professional		$18.00	$21.60	$24.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.25 / $13.25 / $13.25	Professional		$13.25	$13.25	$13.25
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 $6,634.28 / $6,634.28 / $6,634.28	Facility		$6,634.28	$6,634.28	$6,634.28
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $6,634.28 / $6,634.28 / $6,634.28	Professional		$6,634.28	$6,634.28	$6,634.28