Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $171.15 / $171.15 / $171.15	Facility		$171.15	$171.15	$171.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.15 / $171.15 / $392.08	Professional		$171.15	$171.15	$392.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $868.47 / $1,181.15 / $2,285.07	Facility		$868.47	$1,181.15	$2,285.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $650.00 / $904.63	Professional		$66.64	$650.00	$904.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $424.58 / $445.60 / $533.88	Professional		$424.58	$445.60	$533.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $387.85 / $1,076.88 / $1,865.31	Facility		$387.85	$1,076.88	$1,865.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $34.64 / $51.25	Professional		$20.50	$34.64	$51.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $629.00 / $1,009.00 / $79,999.20	Facility		$629.00	$1,009.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $861.87 / $1,181.15 / $2,259.41	Facility		$861.87	$1,181.15	$2,259.41
United Facility/Professional Professional Modifier Low / Median / High Price $699.93 / $699.93 / $699.93	Professional		$699.93	$699.93	$699.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $129.32 / $129.32 / $387.85	Professional		$129.32	$129.32	$387.85