Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.79 / $193.82 / $415.09	Professional		$164.79	$193.82	$415.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $787.09 / $1,682.37	Facility		$100.00	$787.09	$1,682.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $32.19 / $210.49 / $387.73	Professional		$32.19	$210.49	$387.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $238.16 / $238.16 / $238.16	Facility		$238.16	$238.16	$238.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.44 / $238.16 / $287.73	Professional		$202.44	$238.16	$287.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $387.73 / $387.73 / $387.73	Facility		$387.73	$387.73	$387.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $387.73 / $387.73 / $387.73	Professional		$387.73	$387.73	$387.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $246.40 / $308.01 / $338.81	Professional		$246.40	$308.01	$338.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $321.83 / $378.64 / $387.73	Facility		$321.83	$378.64	$387.73
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $329.57 / $387.73 / $387.73	Professional		$329.57	$387.73	$387.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.96 / $339.50 / $339.50	Facility		$33.96	$339.50	$339.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.19 / $321.83 / $682.72	Professional		$32.19	$321.83	$682.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $378.64 / $378.64 / $378.64	Facility		$378.64	$378.64	$378.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.19 / $26.19 / $31.89	Professional		$26.19	$26.19	$31.89
United Facility/Professional Professional Modifier Low / Median / High Price $152.02 / $164.42 / $313.68	Professional		$152.02	$164.42	$313.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $237.03 / $237.03 / $237.03	Professional		$237.03	$237.03	$237.03