Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.10 / $174.10 / $946.94	Facility		$174.10	$174.10	$946.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.88 / $174.10 / $253.70	Professional		$89.88	$174.10	$253.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $559.17 / $747.08 / $1,391.69	Facility		$559.17	$747.08	$1,391.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $203.48 / $650.00 / $1,012.73	Professional		$203.48	$650.00	$1,012.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.72 / $161.72 / $161.72	Professional		$161.72	$161.72	$161.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $248.99 / $743.43 / $1,260.25	Facility		$248.99	$743.43	$1,260.25
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 $383.00 / $614.00 / $79,999.20	Facility		$383.00	$614.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $549.48 / $733.08 / $1,376.06	Facility		$549.48	$733.08	$1,376.06
United Facility/Professional Professional Modifier Low / Median / High Price $269.67 / $269.67 / $269.67	Professional		$269.67	$269.67	$269.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.69 / $137.69 / $248.99	Professional		$137.69	$137.69	$248.99