Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.36 / $64.38 / $67.20	Facility		$28.36	$64.38	$67.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $28.36 / $55.00	Professional		$28.36	$28.36	$55.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $12.80 / $100.00 / $100.00	Facility		$12.80	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $11.52 / $22.60 / $32.00	Professional		$11.52	$22.60	$32.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.60 / $12.60 / $12.60	Facility		$12.60	$12.60	$12.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $10.71 / $12.60	Professional		$10.71	$10.71	$12.60
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 $20.61 / $20.61 / $20.61	Facility		$20.61	$20.61	$20.61
United Facility/Professional Professional Modifier Low / Median / High Price $13.25 / $17.66 / $22.08	Professional		$13.25	$17.66	$22.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00