Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,492.79 / $2,492.79 / $2,492.79	Facility		$2,492.79	$2,492.79	$2,492.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8.88 / $100.00 / $100.00	Facility		$8.88	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $22.20 / $29.60 / $75.00	Professional		$22.20	$29.60	$75.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $0.80 / $0.80	Professional		$0.80	$0.80	$0.80
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 $60.00 / $76.50 / $93.50	Professional		$60.00	$76.50	$93.50
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