Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.90 / $14.90 / $14.90	Facility		$14.90	$14.90	$14.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.02 / $14.55 / $15.08	Professional		$14.02	$14.55	$15.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $90.00 / $146.62	Facility		$85.00	$90.00	$146.62
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $27.81 / $60.00 / $99.28	Professional		$27.81	$60.00	$99.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.05 / $62.05 / $248.20	Facility		$62.05	$62.05	$248.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $62.05 / $76.09	Professional		$62.05	$62.05	$76.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $62.05 / $62.05 / $83.77	Facility		$62.05	$62.05	$83.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $62.05 / $77.56	Professional		$62.05	$62.05	$77.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $75.00 / $75.00	Professional		$70.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.05 / $62.05 / $62.05	Facility		$62.05	$62.05	$62.05
United Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $62.05 / $68.26	Professional		$62.05	$62.05	$68.26