Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.05 / $31.89 / $33.29	Facility		$14.05	$31.89	$33.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.05 / $14.05 / $24.31	Professional		$14.05	$14.05	$24.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6.96 / $90.00 / $100.00	Facility		$6.96	$90.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $20.30 / $65.38 / $75.00	Professional		$20.30	$65.38	$75.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10.75 / $10.75 / $10.75	Facility		$10.75	$10.75	$10.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.85 / $7.85 / $10.75	Professional		$7.85	$7.85	$10.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $0.80 / $0.80 / $1.20	Facility		$0.80	$0.80	$1.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $0.80 / $1.20	Professional		$0.80	$0.80	$1.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19.14 / $19.14 / $19.14	Facility		$19.14	$19.14	$19.14
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $19.14 / $19.14	Professional		$19.14	$19.14	$19.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2.14 / $2.14 / $65.38	Professional		$2.14	$2.14	$65.38