Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.77 / $137.77 / $137.77	Facility		$137.77	$137.77	$137.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.66 / $137.77 / $137.77	Professional		$129.66	$137.77	$137.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $162.08 / $162.08 / $163.61	Facility		$162.08	$162.08	$163.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $162.08 / $238.54	Professional		$40.00	$162.08	$238.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.08 / $162.08 / $324.16	Facility		$162.08	$162.08	$324.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $198.77	Professional		$162.08	$162.08	$198.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $406.82 / $406.82 / $406.82	Professional		$406.82	$406.82	$406.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$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
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $35.45 / $35.45 / $39.00	Facility		$35.45	$35.45	$39.00
United Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $194.50	Professional		$162.08	$162.08	$194.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $162.08	Professional		$162.08	$162.08	$162.08