Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.25 / $66.17 / $90.65	Facility		$38.25	$66.17	$90.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.45 / $38.25 / $38.70	Professional		$36.45	$38.25	$38.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $42.75 / $42.75 / $168.75	Facility		$42.75	$42.75	$168.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $42.75 / $280.42	Professional		$42.75	$42.75	$280.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.25 / $38.25 / $76.50	Facility		$38.25	$38.25	$76.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $38.25 / $38.25	Professional		$38.25	$38.25	$38.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.14 / $116.56 / $292.32	Facility		$91.14	$116.56	$292.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.17 / $126.56 / $296.27	Professional		$87.17	$126.56	$296.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.02 / $47.02 / $75.00	Professional		$47.02	$47.02	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.75 / $42.75 / $42.75	Facility		$42.75	$42.75	$42.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $42.75 / $42.75	Professional		$42.75	$42.75	$42.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $42.75 / $42.75 / $42.75	Facility		$42.75	$42.75	$42.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $40.61 / $42.75 / $42.75	Professional		$40.61	$42.75	$42.75
United Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $37.50 / $45.00	Professional		$37.50	$37.50	$45.00