Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $836.47 / $1,269.58 / $3,181.09	Facility		$836.47	$1,269.58	$3,181.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $836.47 / $836.47 / $1,032.19	Professional		$836.47	$836.47	$1,032.19
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,274.56 / $1,702.85 / $3,172.12	Facility		$1,274.56	$1,702.85	$3,172.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $343.54 / $530.91 / $675.37	Professional		$343.54	$530.91	$675.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $360.74 / $360.74 / $360.74	Professional		$360.74	$360.74	$360.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $596.13 / $1,711.71 / $3,147.66	Facility		$596.13	$1,711.71	$3,147.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $44.00 / $75.00	Professional		$40.00	$44.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $874.00 / $1,400.00 / $79,999.20	Facility		$874.00	$1,400.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,252.45 / $1,670.93 / $3,136.51	Facility		$1,252.45	$1,670.93	$3,136.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $343.54 / $343.54 / $343.54	Professional		$343.54	$343.54	$343.54