Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.07 / $237.24 / $371.61	Professional		$178.07	$237.24	$371.61
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,497.41 / $1,497.41	Facility		$100.00	$1,497.41	$1,497.41
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $51.92 / $360.26 / $454.66	Professional		$51.92	$360.26	$454.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $256.50 / $256.50 / $386.04	Facility		$256.50	$256.50	$386.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.03 / $256.50 / $386.04	Professional		$218.03	$256.50	$386.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $429.20 / $429.20 / $429.20	Facility		$429.20	$429.20	$429.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $429.20 / $429.20 / $429.20	Professional		$429.20	$429.20	$429.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $401.36 / $501.70 / $551.87	Professional		$401.36	$501.70	$551.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $465.30 / $514.66 / $566.82	Facility		$465.30	$514.66	$566.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $465.30 / $558.88 / $566.82	Professional		$465.30	$558.88	$566.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.63 / $41.63 / $41.63	Facility		$41.63	$41.63	$41.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.42 / $354.20 / $839.35	Professional		$35.42	$354.20	$839.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $42.64 / $51.92	Professional		$42.64	$42.64	$51.92
United Facility/Professional Professional Modifier Low / Median / High Price $183.19 / $212.60 / $305.32	Professional		$183.19	$212.60	$305.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $328.12 / $328.12 / $328.12	Professional		$328.12	$328.12	$328.12