Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.06 / $79.06 / $3,416.25	Facility		$79.06	$79.06	$3,416.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.10 / $71.20 / $103.45	Professional		$30.10	$71.20	$103.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $200.17 / $288.91 / $505.65	Facility		$200.17	$288.91	$505.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $87.32 / $200.55 / $620.54	Professional		$87.32	$200.55	$620.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.23 / $297.08 / $374.65	Facility		$127.23	$297.08	$374.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.64 / $144.26 / $235.44	Professional		$70.64	$144.26	$235.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $67.91 / $126.24 / $260.05	Facility		$67.91	$126.24	$260.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.89 / $127.46 / $192.90	Professional		$62.89	$127.46	$192.90
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 $89.32 / $136.01 / $136.01	Facility		$89.32	$136.01	$136.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $166.99 / $251.80 / $489.71	Facility		$166.99	$251.80	$489.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $87.32 / $158.75 / $234.52	Professional		$87.32	$158.75	$234.52