Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.34 / $186.91 / $195.15	Facility		$82.34	$186.91	$195.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.54 / $82.34 / $86.44	Professional		$46.54	$82.34	$86.44
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $104.77 / $431.88 / $431.88	Facility		$104.77	$431.88	$431.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $102.36 / $710.25	Professional		$39.00	$102.36	$710.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.95 / $37.95 / $37.95	Facility		$37.95	$37.95	$37.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.70 / $27.70 / $37.95	Professional		$27.70	$27.70	$37.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $76.56 / $172.28 / $277.79	Facility		$76.56	$172.28	$277.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.56 / $162.47 / $223.61	Professional		$76.56	$162.47	$223.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.54 / $61.72 / $123.44	Professional		$55.54	$61.72	$123.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.83 / $148.44 / $163.47	Facility		$62.83	$148.44	$163.47
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $62.83 / $62.83 / $62.83	Professional		$62.83	$62.83	$62.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $101.53 / $121.83 / $222.59	Facility		$101.53	$121.83	$222.59
United Facility/Professional Professional Modifier Low / Median / High Price $52.42 / $58.14 / $88.06	Professional		$52.42	$58.14	$88.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.06 / $115.01 / $115.01	Professional		$70.06	$115.01	$115.01