Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $424.47 / $424.47 / $424.47	Facility		$424.47	$424.47	$424.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.50 / $424.47 / $424.47	Professional		$399.50	$424.47	$424.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $414.49 / $474.41 / $1,872.68	Facility		$414.49	$474.41	$1,872.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $424.47 / $1,897.64 / $2,247.21	Professional		$424.47	$1,897.64	$2,247.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $424.47 / $424.47 / $848.94	Facility		$424.47	$424.47	$848.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $424.47 / $424.47 / $424.47	Professional		$424.47	$424.47	$424.47
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 / $75.00 / $75.00	Professional		$50.00	$75.00	$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 $414.49 / $414.49 / $424.47	Facility		$414.49	$414.49	$424.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $384.52 / $424.47 / $449.44	Professional		$384.52	$424.47	$449.44
United Facility/Professional Professional Modifier Low / Median / High Price $499.42 / $499.42 / $599.29	Professional		$499.42	$499.42	$599.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $424.47 / $424.47 / $424.47	Professional		$424.47	$424.47	$424.47