Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $973.77 / $973.77 / $973.77	Facility		$973.77	$973.77	$973.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $973.77 / $973.77 / $1,194.00	Professional		$973.77	$973.77	$1,194.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,709.45 / $4,709.45 / $4,709.45	Facility		$4,709.45	$4,709.45	$4,709.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $108.91 / $118.36	Professional		$30.00	$108.91	$118.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,264.25 / $2,264.25 / $2,264.25	Professional		$2,264.25	$2,264.25	$2,264.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,505.00 / $5,505.00 / $5,505.00	Facility		$5,505.00	$5,505.00	$5,505.00
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 $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,738.11 / $3,738.11 / $4,709.45	Facility		$3,738.11	$3,738.11	$4,709.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $603.29 / $603.29	Professional		$20.39	$603.29	$603.29