Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.83 / $70.83 / $70.83	Facility		$70.83	$70.83	$70.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.49 / $58.70 / $77.17	Professional		$39.49	$58.70	$77.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $107.00 / $327.45 / $327.45	Facility		$107.00	$327.45	$327.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $44.33 / $368.87 / $538.50	Professional		$44.33	$368.87	$538.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.86 / $50.86 / $50.86	Professional		$50.86	$50.86	$50.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.35 / $107.22 / $165.88	Facility		$57.35	$107.22	$165.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.35 / $107.22 / $164.22	Professional		$57.35	$107.22	$164.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $80.00	Professional		$50.00	$50.00	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.49 / $122.21 / $123.95	Facility		$86.49	$122.21	$123.95
United Facility/Professional Facility Modifier Low / Median / High Price $140.62 / $140.62 / $140.62	Facility		$140.62	$140.62	$140.62
United Facility/Professional Professional Modifier Low / Median / High Price $60.55 / $60.55 / $60.55	Professional		$60.55	$60.55	$60.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $84.00 / $84.00	Professional		$84.00	$84.00	$84.00