Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.71 / $242.71 / $242.71	Facility		$242.71	$242.71	$242.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.71 / $242.71 / $311.20	Professional		$242.71	$242.71	$311.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $583.48 / $1,632.30 / $3,157.85	Facility		$583.48	$1,632.30	$3,157.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $100.00 / $500.00	Professional		$36.65	$100.00	$500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.04 / $116.04 / $116.04	Professional		$116.04	$116.04	$116.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $204.20 / $521.79 / $1,318.89	Facility		$204.20	$521.79	$1,318.89
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 $870.00 / $1,394.00 / $79,999.20	Facility		$870.00	$1,394.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $583.48 / $1,596.08 / $3,122.40	Facility		$583.48	$1,596.08	$3,122.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $172.72 / $172.72 / $172.72	Professional		$172.72	$172.72	$172.72