Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.74 / $199.17 / $207.94	Facility		$87.74	$199.17	$207.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.59 / $87.74 / $92.29	Professional		$49.59	$87.74	$92.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $111.65 / $460.20 / $460.20	Facility		$111.65	$460.20	$460.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $50.66 / $82.15 / $756.83	Professional		$50.66	$82.15	$756.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.84 / $69.84 / $69.84	Facility		$69.84	$69.84	$69.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.99 / $50.99 / $69.84	Professional		$50.99	$50.99	$69.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $81.53 / $173.00 / $234.82	Facility		$81.53	$173.00	$234.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.53 / $173.00 / $238.01	Professional		$81.53	$173.00	$238.01
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 $143.00 / $163.34 / $174.20	Facility		$143.00	$163.34	$174.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $163.34 / $163.34 / $163.34	Professional		$163.34	$163.34	$163.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $108.19 / $129.83 / $237.18	Facility		$108.19	$129.83	$237.18
United Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $65.68 / $93.83	Professional		$56.22	$65.68	$93.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.94 / $74.94 / $82.15	Professional		$74.94	$74.94	$82.15