Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.12 / $255.20 / $402.21	Professional		$255.12	$255.20	$402.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,290.40 / $2,290.40	Facility		$100.00	$2,290.40	$2,290.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.36 / $375.58 / $535.91	Professional		$42.36	$375.58	$535.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.77 / $172.77 / $172.77	Facility		$172.77	$172.77	$172.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.86 / $146.85 / $286.20	Professional		$37.86	$146.85	$286.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $510.40 / $510.40 / $510.40	Facility		$510.40	$510.40	$510.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $510.40 / $510.40 / $510.40	Professional		$510.40	$510.40	$510.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $312.96 / $391.21 / $430.33	Professional		$312.96	$391.21	$430.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $431.43 / $787.22 / $866.98	Facility		$431.43	$787.22	$866.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $711.70 / $854.84 / $866.98	Professional		$711.70	$854.84	$866.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.69 / $44.69 / $44.69	Facility		$44.69	$44.69	$44.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.36 / $365.14 / $898.73	Professional		$42.36	$365.14	$898.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $34.46 / $34.46 / $41.96	Professional		$34.46	$34.46	$41.96
United Facility/Professional Professional Modifier Low / Median / High Price $200.03 / $214.81 / $358.01	Professional		$200.03	$214.81	$358.01