Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $220.19 / $229.89	Facility		$97.00	$220.19	$229.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $97.00 / $97.00	Professional		$88.00	$97.00	$97.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $42.34 / $100.00 / $100.00	Facility		$42.34	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $37.70 / $37.70 / $141.13	Professional		$37.70	$37.70	$141.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.60 / $94.60 / $94.60	Facility		$94.60	$94.60	$94.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $69.06 / $94.60	Professional		$60.00	$69.06	$94.60
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 $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $244.46 / $244.46 / $244.46	Facility		$244.46	$244.46	$244.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.70 / $37.70 / $37.70	Professional		$37.70	$37.70	$37.70