Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.99 / $198.65 / $465.09	Professional		$146.99	$198.65	$465.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,745.64 / $1,745.64	Facility		$100.00	$1,745.64	$1,745.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.86 / $292.14 / $484.31	Professional		$42.86	$292.14	$484.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.42 / $243.42 / $325.88	Facility		$243.42	$243.42	$325.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.91 / $243.42 / $325.88	Professional		$206.91	$243.42	$325.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $361.91 / $361.91 / $361.91	Facility		$361.91	$361.91	$361.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $361.91 / $361.91 / $361.91	Professional		$361.91	$361.91	$361.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $359.67 / $439.60	Professional		$75.00	$359.67	$439.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $361.91 / $389.05 / $509.09	Facility		$361.91	$389.05	$509.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $361.91 / $389.05 / $470.48	Professional		$361.91	$389.05	$470.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.86 / $348.63 / $348.63	Facility		$34.86	$348.63	$348.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.87 / $298.66 / $373.10	Professional		$29.87	$298.66	$373.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $351.37 / $351.37 / $351.37	Facility		$351.37	$351.37	$351.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $35.20 / $35.20 / $42.86	Professional		$35.20	$35.20	$42.86
United Facility/Professional Professional Modifier Low / Median / High Price $182.68 / $213.12 / $350.89	Professional		$182.68	$213.12	$350.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $292.14 / $292.14 / $292.14	Professional		$292.14	$292.14	$292.14