Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Facility		$147.90	$147.90	$147.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $147.90 / $147.90	Professional		$139.19	$147.90	$147.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $144.41 / $165.30 / $652.50	Facility		$144.41	$165.30	$652.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $661.20 / $783.00	Professional		$147.90	$661.20	$783.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $122.40 / $147.90 / $295.80	Facility		$122.40	$147.90	$295.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.63 / $75.63 / $75.63	Professional		$75.63	$75.63	$75.63
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
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.41 / $144.41 / $147.90	Facility		$144.41	$144.41	$147.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.97 / $147.90 / $156.60	Professional		$133.97	$147.90	$156.60
United Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $145.00 / $174.00	Professional		$145.00	$145.00	$174.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $143.55 / $143.55 / $143.55	Professional		$143.55	$143.55	$143.55