Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.10 / $204.53 / $213.54	Facility		$90.10	$204.53	$213.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.93 / $90.10 / $90.10	Professional		$50.93	$90.10	$90.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $114.66 / $472.60 / $472.60	Facility		$114.66	$472.60	$472.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $93.66 / $130.88 / $777.23	Professional		$93.66	$130.88	$777.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.05 / $75.05 / $75.05	Facility		$75.05	$75.05	$75.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.79 / $54.79 / $76.53	Professional		$54.79	$54.79	$76.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.70 / $188.32 / $303.97	Facility		$83.70	$188.32	$303.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.70 / $177.60 / $244.07	Professional		$83.70	$177.60	$244.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $80.00	Professional		$45.00	$50.00	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $146.85 / $176.39 / $245.71	Facility		$146.85	$176.39	$245.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $245.71 / $245.71 / $245.71	Professional		$245.71	$245.71	$245.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $111.10 / $133.32 / $243.57	Facility		$111.10	$133.32	$243.57
United Facility/Professional Professional Modifier Low / Median / High Price $57.36 / $68.16 / $96.36	Professional		$57.36	$68.16	$96.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.84 / $155.05 / $155.05	Professional		$131.84	$155.05	$155.05