Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.62 / $671.88 / $1,061.46	Professional		$450.62	$671.88	$1,061.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $117.94 / $7,110.09 / $7,110.09	Facility		$117.94	$7,110.09	$7,110.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $764.71 / $1,014.01 / $1,370.20	Professional		$764.71	$1,014.01	$1,370.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $833.40 / $833.40 / $833.40	Facility		$833.40	$833.40	$833.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.30 / $833.40 / $1,000.08	Professional		$116.30	$833.40	$1,000.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,354.80 / $1,354.80 / $1,354.80	Facility		$1,354.80	$1,354.80	$1,354.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,354.80 / $1,354.80 / $1,354.80	Professional		$1,354.80	$1,354.80	$1,354.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.96 / $1,056.00 / $1,161.59	Professional		$126.96	$1,056.00	$1,161.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,351.43 / $2,443.78 / $2,691.39	Facility		$1,351.43	$2,443.78	$2,691.39
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,209.35 / $2,653.71 / $2,691.39	Professional		$2,209.35	$2,653.71	$2,691.39
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.94 / $117.94 / $117.94	Facility		$117.94	$117.94	$117.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $237.84 / $1,202.99 / $2,378.36	Professional		$237.84	$1,202.99	$2,378.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.02 / $93.02 / $113.26	Professional		$93.02	$93.02	$113.26
United Facility/Professional Professional Modifier Low / Median / High Price $626.57 / $668.58 / $1,170.02	Professional		$626.57	$668.58	$1,170.02