Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.86 / $128.25 / $203.31	Professional		$124.86	$128.25	$203.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,325.73 / $1,325.73	Facility		$100.00	$1,325.73	$1,325.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $206.74 / $270.58	Professional		$23.32	$206.74	$270.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.27 / $174.27 / $174.27	Facility		$174.27	$174.27	$174.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.19 / $148.13 / $307.50	Professional		$22.19	$148.13	$307.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $242.40 / $242.40 / $242.40	Facility		$242.40	$242.40	$242.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $242.40 / $242.40 / $242.40	Professional		$242.40	$242.40	$242.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $188.24 / $219.20 / $258.83	Professional		$188.24	$219.20	$258.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $224.98 / $296.45 / $361.13	Facility		$224.98	$296.45	$361.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $296.45 / $361.13 / $361.13	Professional		$296.45	$361.13	$361.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.92 / $21.92 / $21.92	Facility		$21.92	$21.92	$21.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $228.24 / $270.58	Professional		$20.00	$228.24	$270.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $19.14 / $23.32	Professional		$19.14	$19.14	$23.32
United Facility/Professional Professional Modifier Low / Median / High Price $111.13 / $116.71 / $194.52	Professional		$111.13	$116.71	$194.52