Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.13 / $71.81 / $154.66	Facility		$68.13	$71.81	$154.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.13 / $68.13 / $91.87	Professional		$68.13	$68.13	$91.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $16.55 / $100.00 / $100.00	Facility		$16.55	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $49.68 / $55.20	Professional		$41.40	$49.68	$55.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.29 / $35.29 / $35.29	Professional		$35.29	$35.29	$35.29
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 $1,071.43 / $1,071.43 / $1,071.43	Facility		$1,071.43	$1,071.43	$1,071.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,071.43 / $1,071.43 / $1,071.43	Professional		$1,071.43	$1,071.43	$1,071.43