Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.35 / $245.98 / $1,507.96	Facility		$108.35	$245.98	$1,507.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.81 / $108.36 / $144.66	Professional		$105.81	$108.36	$144.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $109.25 / $415.06 / $431.25	Facility		$109.25	$415.06	$431.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $106.24 / $437.00 / $517.50	Professional		$106.24	$437.00	$517.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.36 / $108.36 / $216.72	Facility		$108.36	$108.36	$216.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $108.36 / $108.36	Professional		$108.36	$108.36	$108.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $100.75 / $202.10 / $397.50	Facility		$100.75	$202.10	$397.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.80 / $237.49 / $363.58	Professional		$121.80	$237.49	$363.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $209.28 / $272.06 / $523.20	Professional		$209.28	$272.06	$523.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $151.80 / $220.23 / $231.15	Facility		$151.80	$220.23	$231.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.25 / $109.25 / $109.25	Facility		$109.25	$109.25	$109.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.25 / $109.25 / $109.25	Professional		$109.25	$109.25	$109.25
United Facility/Professional Professional Modifier Low / Median / High Price $106.24 / $106.24 / $127.49	Professional		$106.24	$106.24	$127.49