Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Facility		$48.56	$48.56	$48.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.70 / $48.56 / $48.56	Professional		$45.70	$48.56	$48.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $47.42 / $181.78 / $520.84	Facility		$47.42	$181.78	$520.84
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $51.42 / $548.62 / $625.01	Professional		$51.42	$548.62	$625.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $48.56 / $194.24	Facility		$48.56	$48.56	$194.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Professional		$48.56	$48.56	$48.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $397.49 / $397.49 / $397.49	Professional		$397.49	$397.49	$397.49
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 $147.22 / $147.22 / $79,999.20	Facility		$147.22	$147.22	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.42 / $47.42 / $48.56	Facility		$47.42	$47.42	$48.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $48.56 / $51.42	Professional		$43.99	$48.56	$51.42
United Facility/Professional Facility Modifier Low / Median / High Price $3,704.26 / $3,704.26 / $3,704.26	Facility		$3,704.26	$3,704.26	$3,704.26
United Facility/Professional Professional Modifier Low / Median / High Price $57.13 / $57.13 / $68.56	Professional		$57.13	$57.13	$68.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.22 / $147.22 / $147.22	Professional		$147.22	$147.22	$147.22