Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.05 / $61.05 / $61.05	Facility		$61.05	$61.05	$61.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.09 / $52.83 / $61.05	Professional		$20.09	$52.83	$61.05
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $116.58 / $371.87 / $371.87	Facility		$116.58	$371.87	$371.87
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $54.99 / $382.72 / $613.20	Professional		$54.99	$382.72	$613.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.70 / $27.70 / $27.70	Professional		$27.70	$27.70	$27.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.49 / $51.32 / $130.41	Facility		$28.49	$51.32	$130.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.42 / $49.33 / $141.90	Professional		$25.42	$49.33	$141.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $65.00	Professional		$45.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $93.64 / $139.51 / $142.71	Facility		$93.64	$139.51	$142.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.07 / $55.07 / $156.00	Professional		$55.07	$55.07	$156.00
United Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $129.00 / $136.00	Professional		$129.00	$129.00	$136.00