Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.12 / $266.82 / $600.01	Professional		$254.12	$266.82	$600.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $44.60 / $1,111.60 / $2,490.09	Facility		$44.60	$1,111.60	$2,490.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $47.57 / $424.60 / $607.54	Professional		$47.57	$424.60	$607.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $347.16 / $347.16 / $455.65	Facility		$347.16	$347.16	$455.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.08 / $347.16 / $455.65	Professional		$295.08	$347.16	$455.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $492.90 / $492.90 / $492.90	Facility		$492.90	$492.90	$492.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $492.90 / $492.90 / $492.90	Professional		$492.90	$492.90	$492.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.29 / $369.67 / $578.62	Professional		$49.29	$369.67	$578.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $492.90 / $533.64 / $578.62	Facility		$492.90	$533.64	$578.62
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $468.26 / $492.90 / $578.62	Professional		$468.26	$492.90	$578.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.60 / $446.05 / $446.05	Facility		$44.60	$446.05	$446.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.67 / $406.76 / $550.32	Professional		$40.67	$406.76	$550.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $478.54 / $478.54 / $478.54	Facility		$478.54	$478.54	$478.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.07 / $39.07 / $47.57	Professional		$39.07	$39.07	$47.57
United Facility/Professional Professional Modifier Low / Median / High Price $226.87 / $252.90 / $442.58	Professional		$226.87	$252.90	$442.58