Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.65 / $85.06 / $9,675.00	Facility		$83.65	$85.06	$9,675.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $2,088.90 / $8,977.95	Professional		$33.29	$2,088.90	$8,977.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $214.40	Facility		$100.00	$100.00	$214.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $774.00 / $774.00	Professional		$75.00	$774.00	$774.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.89 / $269.89 / $269.89	Facility		$269.89	$269.89	$269.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.41 / $229.41 / $269.89	Professional		$229.41	$229.41	$269.89
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 $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20