Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $243.45 / $509.55 / $552.63	Facility		$243.45	$509.55	$552.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.79 / $215.00 / $371.95	Professional		$142.79	$215.00	$371.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $261.95 / $527.58 / $1,453.18	Facility		$261.95	$527.58	$1,453.18
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,409.81 / $1,409.81 / $2,389.94	Professional		$1,409.81	$1,409.81	$2,389.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.94 / $160.94 / $160.94	Professional		$160.94	$160.94	$160.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $900.21 / $900.21 / $900.21	Professional		$900.21	$900.21	$900.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $75.00 / $285.28	Professional		$50.00	$75.00	$285.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $327.44 / $499.46 / $550.07	Facility		$327.44	$499.46	$550.07
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $327.44 / $327.44 / $327.44	Professional		$327.44	$327.44	$327.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $261.95 / $261.95 / $261.95	Facility		$261.95	$261.95	$261.95
United Facility/Professional Professional Modifier Low / Median / High Price $144.59 / $165.13 / $261.95	Professional		$144.59	$165.13	$261.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $375.00 / $375.00	Professional		$375.00	$375.00	$375.00