Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $14.40 / $422.00	Professional		$14.40	$14.40	$422.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $12.00 / $100.00 / $100.00	Facility		$12.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $40.00 / $75.00	Professional		$30.00	$40.00	$75.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.92 / $34.92 / $34.92	Facility		$34.92	$34.92	$34.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $5.25 / $5.25	Professional		$5.25	$5.25	$5.25
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 $45.00 / $60.00 / $85.00	Professional		$45.00	$60.00	$85.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,105.71 / $1,105.71 / $1,105.71	Facility		$1,105.71	$1,105.71	$1,105.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,105.71 / $1,105.71 / $1,105.71	Professional		$1,105.71	$1,105.71	$1,105.71