Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $567.12	Facility		$100.00	$100.00	$567.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,417.80 / $1,701.36 / $1,890.40	Professional		$1,417.80	$1,701.36	$1,890.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,051.59 / $1,051.59 / $1,051.59	Facility		$1,051.59	$1,051.59	$1,051.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $893.86 / $893.86 / $1,051.59	Professional		$893.86	$893.86	$1,051.59
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 $5,528.56 / $5,528.56 / $5,528.56	Facility		$5,528.56	$5,528.56	$5,528.56
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,528.56 / $5,528.56 / $5,528.56	Professional		$5,528.56	$5,528.56	$5,528.56