Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $59.81 / $235.60	Facility		$20.00	$59.81	$235.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $33.46	Professional		$20.00	$20.00	$33.46
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 $8.64 / $55.80 / $75.00	Professional		$8.64	$55.80	$75.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.89 / $117.89 / $117.89	Professional		$117.89	$117.89	$117.89
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 / $55.00 / $85.00	Professional		$45.00	$55.00	$85.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $239.20 / $239.20 / $239.20	Facility		$239.20	$239.20	$239.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $239.20 / $239.20 / $239.20	Professional		$239.20	$239.20	$239.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $55.80 / $55.80	Professional		$55.80	$55.80	$55.80