Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.91 / $249.72 / $392.49	Professional		$171.91	$249.72	$392.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,575.35 / $2,575.35	Facility		$100.00	$2,575.35	$2,575.35
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $393.87 / $525.32	Professional		$50.12	$393.87	$525.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $235.00 / $238.50 / $238.50	Facility		$235.00	$238.50	$238.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.11 / $238.50 / $642.00	Professional		$43.11	$238.50	$642.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $470.50 / $470.50 / $470.50	Facility		$470.50	$470.50	$470.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $470.50 / $470.50 / $470.50	Professional		$470.50	$470.50	$470.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $420.52 / $467.25 / $513.97	Professional		$420.52	$467.25	$513.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $432.85 / $515.36 / $527.29	Facility		$432.85	$515.36	$527.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $432.85 / $527.29 / $527.29	Professional		$432.85	$527.29	$527.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.83 / $43.83 / $43.83	Facility		$43.83	$43.83	$43.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.83 / $388.28 / $525.32	Professional		$38.83	$388.28	$525.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $41.16 / $50.12	Professional		$41.16	$41.16	$50.12
United Facility/Professional Facility Modifier Low / Median / High Price $21.91 / $151.22 / $226.90	Facility		$21.91	$151.22	$226.90
United Facility/Professional Professional Modifier Low / Median / High Price $170.42 / $205.09 / $284.02	Professional		$170.42	$205.09	$284.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $332.42 / $332.42 / $332.42	Professional		$332.42	$332.42	$332.42