Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.97 / $179.26 / $187.16	Facility		$78.97	$179.26	$187.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.63 / $78.97 / $78.97	Professional		$44.63	$78.97	$78.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.48 / $414.18 / $414.18	Facility		$100.48	$414.18	$414.18
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $98.39 / $681.15	Professional		$53.77	$98.39	$681.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.13 / $47.13 / $47.13	Facility		$47.13	$47.13	$47.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $34.40 / $47.13	Professional		$34.40	$34.40	$47.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $73.47 / $155.88 / $211.18	Facility		$73.47	$155.88	$211.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.47 / $155.88 / $213.75	Professional		$73.47	$155.88	$213.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $127.74 / $142.36 / $156.78	Facility		$127.74	$142.36	$156.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $127.74 / $127.74 / $127.74	Professional		$127.74	$127.74	$127.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $97.36 / $116.84 / $213.46	Facility		$97.36	$116.84	$213.46
United Facility/Professional Professional Modifier Low / Median / High Price $50.27 / $55.76 / $84.45	Professional		$50.27	$55.76	$84.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.91 / $85.35 / $85.35	Professional		$70.91	$85.35	$85.35