Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.73 / $259.31 / $597.54	Professional		$188.73	$259.31	$597.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,391.90 / $2,391.90	Facility		$100.00	$2,391.90	$2,391.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $55.02 / $398.43 / $638.45	Professional		$55.02	$398.43	$638.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $333.25 / $333.25 / $440.85	Facility		$333.25	$333.25	$440.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $283.26 / $333.25 / $440.85	Professional		$283.26	$333.25	$440.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $476.23 / $476.23 / $476.23	Facility		$476.23	$476.23	$476.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $476.23 / $476.23 / $476.23	Professional		$476.23	$476.23	$476.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $461.80 / $513.12 / $564.43	Professional		$461.80	$513.12	$564.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $476.23 / $499.99 / $653.64	Facility		$476.23	$499.99	$653.64
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $452.42 / $499.99 / $608.04	Professional		$452.42	$499.99	$608.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.51 / $455.11 / $455.11	Facility		$45.51	$455.11	$455.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $479.05 / $531.71	Professional		$39.29	$479.05	$531.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $462.36 / $462.36 / $462.36	Facility		$462.36	$462.36	$462.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $45.19 / $45.19 / $55.02	Professional		$45.19	$45.19	$55.02
United Facility/Professional Professional Modifier Low / Median / High Price $253.54 / $262.43 / $487.13	Professional		$253.54	$262.43	$487.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $398.43 / $398.43 / $398.43	Professional		$398.43	$398.43	$398.43