Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3.06 / $3.06 / $8.82	Facility		$3.06	$3.06	$8.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.88 / $3.06 / $3.10	Professional		$2.88	$3.06	$3.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3.06 / $109.41 / $139.11	Facility		$3.06	$109.41	$139.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3.15 / $50.16 / $484.17	Professional		$3.15	$50.16	$484.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3.06 / $3.06 / $16.20	Facility		$3.06	$3.06	$16.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3.06 / $3.06 / $3.06	Professional		$3.06	$3.06	$3.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2.27 / $6.32 / $89.44	Facility		$2.27	$6.32	$89.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2.54 / $6.61 / $97.64	Professional		$2.54	$6.61	$97.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.05 / $30.00 / $75.00	Professional		$1.05	$30.00	$75.00
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
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2.99 / $2.99 / $3.06	Facility		$2.99	$2.99	$3.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.77 / $3.24 / $3.60	Professional		$2.77	$3.24	$3.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $50.16 / $50.16 / $50.16	Facility		$50.16	$50.16	$50.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.65 / $50.16 / $50.16	Professional		$47.65	$50.16	$50.16
United Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $3.00 / $3.03	Professional		$3.00	$3.00	$3.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $3.00 / $3.00	Professional		$3.00	$3.00	$3.00