Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.82 / $276.52 / $288.70	Facility		$121.82	$276.52	$288.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.86 / $121.82 / $121.82	Professional		$68.86	$121.82	$121.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $155.02 / $638.99 / $638.99	Facility		$155.02	$638.99	$638.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $85.54 / $157.91 / $1,050.90	Professional		$85.54	$157.91	$1,050.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.50 / $56.50 / $56.50	Facility		$56.50	$56.50	$56.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $41.25 / $56.50	Professional		$41.25	$41.25	$56.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $113.15 / $254.58 / $410.99	Facility		$113.15	$254.58	$410.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.15 / $240.12 / $330.48	Professional		$113.15	$240.12	$330.48
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 $196.03 / $219.62 / $241.87	Facility		$196.03	$219.62	$241.87
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $196.03 / $196.03 / $196.03	Professional		$196.03	$196.03	$196.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $150.21 / $180.26 / $329.32	Facility		$150.21	$180.26	$329.32
United Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $91.20 / $130.28	Professional		$75.00	$91.20	$130.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $152.51 / $152.51 / $157.91	Professional		$152.51	$152.51	$157.91