Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.26 / $177.26 / $177.26	Facility		$177.26	$177.26	$177.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.83 / $177.26 / $177.26	Professional		$166.83	$177.26	$177.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $187.69 / $280.58 / $782.03	Facility		$187.69	$280.58	$782.03
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $792.45 / $792.45 / $938.43	Professional		$792.45	$792.45	$938.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.26 / $177.26 / $354.52	Facility		$177.26	$177.26	$354.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.26 / $177.26 / $177.26	Professional		$177.26	$177.26	$177.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $874.03 / $874.03 / $874.03	Facility		$874.03	$874.03	$874.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
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 $200.42 / $270.82 / $563.69	Facility		$200.42	$270.82	$563.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $156.41 / $156.41 / $156.41	Professional		$156.41	$156.41	$156.41