Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.52 / $86.27 / $274.43	Facility		$27.52	$86.27	$274.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.00 / $24.00 / $24.00	Professional		$24.00	$24.00	$24.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $90.00 / $100.00	Facility		$80.00	$90.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $26.86 / $40.00	Professional		$14.70	$26.86	$40.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.65 / $7.65 / $32.00	Professional		$7.65	$7.65	$32.00
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 $13.03 / $14.48 / $36.20	Professional		$13.03	$14.48	$36.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4.18 / $4.18 / $4.18	Facility		$4.18	$4.18	$4.18
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4.18 / $4.18 / $4.18	Professional		$4.18	$4.18	$4.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $26.86 / $26.86	Professional		$26.86	$26.86	$26.86