Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.00 / $153.00 / $153.00	Facility		$153.00	$153.00	$153.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $153.00 / $153.00	Professional		$144.00	$153.00	$153.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $149.40 / $180.00 / $675.00	Facility		$149.40	$180.00	$675.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $684.00 / $810.00	Professional		$153.00	$684.00	$810.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $153.00 / $153.00 / $612.00	Facility		$153.00	$153.00	$612.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $153.00 / $153.00	Professional		$153.00	$153.00	$153.00
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 $149.40 / $149.40 / $153.00	Facility		$149.40	$149.40	$153.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.60 / $153.00 / $162.00	Professional		$138.60	$153.00	$162.00
United Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $180.00 / $216.00	Professional		$180.00	$180.00	$216.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $135.00 / $135.00	Professional		$135.00	$135.00	$135.00