Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.57 / $44.42 / $46.38	Facility		$19.57	$44.42	$46.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $19.57 / $24.91	Professional		$19.57	$19.57	$24.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6.96 / $100.00 / $100.00	Facility		$6.96	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $17.39 / $75.00 / $189.00	Professional		$17.39	$75.00	$189.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.72 / $23.72 / $23.72	Facility		$23.72	$23.72	$23.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.32 / $17.32 / $23.72	Professional		$17.32	$17.32	$23.72
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 $3.38 / $3.38 / $189.00	Professional		$3.38	$3.38	$189.00