Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.66 / $40.09 / $41.85	Facility		$17.66	$40.09	$41.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.66 / $17.66 / $52.80	Professional		$17.66	$17.66	$52.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $87.40 / $90.90 / $100.00	Facility		$87.40	$90.90	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $76.00 / $80.00	Professional		$36.40	$76.00	$80.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $19.50 / $19.50	Professional		$19.50	$19.50	$19.50
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 $179.39 / $179.39 / $179.39	Facility		$179.39	$179.39	$179.39
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $179.39 / $179.39 / $179.39	Professional		$179.39	$179.39	$179.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $76.00 / $76.00	Professional		$76.00	$76.00	$76.00