Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.03 / $85.03 / $85.03	Facility		$85.03	$85.03	$85.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.03 / $85.03 / $278.77	Professional		$85.03	$85.03	$278.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $150.37 / $212.45 / $377.65	Facility		$150.37	$212.45	$377.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $500.00 / $1,509.57	Professional		$48.96	$500.00	$1,509.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.75 / $126.75 / $126.75	Professional		$126.75	$126.75	$126.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.79 / $228.76 / $486.21	Facility		$72.79	$228.76	$486.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.05 / $63.05 / $63.05	Professional		$63.05	$63.05	$63.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $100.00 / $100.00	Professional		$50.00	$100.00	$100.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $103.00 / $165.00 / $79,999.20	Facility		$103.00	$165.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $147.76 / $200.90 / $377.65	Facility		$147.76	$200.90	$377.65
United Facility/Professional Professional Modifier Low / Median / High Price $89.89 / $89.89 / $89.89	Professional		$89.89	$89.89	$89.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $40.40 / $76.12	Professional		$40.40	$40.40	$76.12