Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.80 / $347.64 / $566.91	Professional		$313.80	$347.64	$566.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $3,203.72 / $3,203.72	Facility		$100.00	$3,203.72	$3,203.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $79.50 / $510.56 / $818.40	Professional		$79.50	$510.56	$818.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $459.79 / $459.79 / $459.79	Facility		$459.79	$459.79	$459.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.82 / $459.79 / $720.00	Professional		$390.82	$459.79	$720.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $614.90 / $614.90 / $614.90	Facility		$614.90	$614.90	$614.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $614.90 / $614.90 / $614.90	Professional		$614.90	$614.90	$614.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $89.12 / $741.17 / $815.28	Professional		$89.12	$741.17	$815.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $948.59 / $1,101.13 / $1,212.70	Facility		$948.59	$1,101.13	$1,212.70
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $995.50 / $1,195.72 / $1,212.70	Professional		$995.50	$1,195.72	$1,212.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.01 / $61.01 / $61.01	Facility		$61.01	$61.01	$61.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.75 / $507.45 / $1,229.88	Professional		$50.75	$507.45	$1,229.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $65.29 / $65.29 / $79.50	Professional		$65.29	$65.29	$79.50
United Facility/Professional Professional Modifier Low / Median / High Price $294.06 / $439.80 / $490.10	Professional		$294.06	$439.80	$490.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $689.16 / $689.16 / $689.16	Professional		$689.16	$689.16	$689.16