Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.06 / $73.06 / $552.00	Facility		$73.06	$73.06	$552.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.34 / $73.06 / $234.60	Professional		$49.34	$73.06	$234.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $66.58 / $106.52 / $1,219.00	Facility		$66.58	$106.52	$1,219.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $76.38 / $1,311.00 / $1,311.00	Professional		$76.38	$1,311.00	$1,311.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $57.66 / $115.32	Facility		$57.66	$57.66	$115.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $57.66 / $70.72	Professional		$57.66	$57.66	$70.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $85.29 / $164.09	Facility		$57.66	$85.29	$164.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.26 / $82.49 / $142.63	Professional		$57.26	$82.49	$142.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $43.39 / $75.00	Professional		$39.45	$43.39	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $88.00 / $105.70 / $107.20	Facility		$88.00	$105.70	$107.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $66.58 / $79.89 / $159.78	Facility		$66.58	$79.89	$159.78
United Facility/Professional Professional Modifier Low / Median / High Price $276.00 / $276.00 / $331.20	Professional		$276.00	$276.00	$331.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $57.66 / $57.66	Professional		$57.66	$57.66	$57.66