Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.13 / $178.13 / $178.13	Facility		$178.13	$178.13	$178.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.65 / $178.13 / $178.13	Professional		$167.65	$178.13	$178.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $173.93 / $209.56 / $785.85	Facility		$173.93	$209.56	$785.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $163.51 / $796.33 / $943.02	Professional		$163.51	$796.33	$943.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.13 / $178.13 / $712.52	Facility		$178.13	$178.13	$712.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.13 / $178.13 / $178.13	Professional		$178.13	$178.13	$178.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12.82 / $12.82 / $12.82	Professional		$12.82	$12.82	$12.82
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
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.93 / $173.93 / $178.13	Facility		$173.93	$173.93	$178.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.36 / $178.13 / $188.60	Professional		$161.36	$178.13	$188.60
United Facility/Professional Professional Modifier Low / Median / High Price $202.90 / $202.90 / $243.48	Professional		$202.90	$202.90	$243.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $155.08 / $155.08 / $155.08	Professional		$155.08	$155.08	$155.08