Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Facility		$85.00	$85.00	$85.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $85.00 / $85.00	Professional		$80.00	$85.00	$85.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $100.00 / $375.00	Facility		$83.00	$100.00	$375.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $380.00 / $450.00	Professional		$85.00	$380.00	$450.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $85.00 / $170.00	Facility		$85.00	$85.00	$170.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5.30 / $5.30 / $5.30	Professional		$5.30	$5.30	$5.30
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 $83.00 / $83.00 / $85.00	Facility		$83.00	$83.00	$85.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $85.00 / $90.00	Professional		$77.00	$85.00	$90.00
United Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $160.91 / $193.10	Professional		$160.91	$160.91	$193.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00