Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $103.00 / $103.00	Professional		$103.00	$103.00	$103.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $731.61 / $1,168.81 / $2,235.80	Facility		$731.61	$1,168.81	$2,235.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $573.00	Professional		$50.00	$50.00	$573.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $513.41 / $780.44 / $1,926.24	Facility		$513.41	$780.44	$1,926.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $384.99 / $384.99 / $3,047.68	Facility		$384.99	$384.99	$3,047.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $589.33 / $589.33 / $589.33	Professional		$589.33	$589.33	$589.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $65.00	Professional		$50.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $332.03 / $998.00 / $1,860.77	Facility		$332.03	$998.00	$1,860.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $757.92 / $1,142.86 / $2,222.71	Facility		$757.92	$1,142.86	$2,222.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Professional		$50.00	$50.00	$50.00