Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.67 / $205.60 / $478.97	Professional		$202.67	$205.60	$478.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,908.97 / $1,908.97	Facility		$100.00	$1,908.97	$1,908.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $41.58 / $323.57 / $495.99	Professional		$41.58	$323.57	$495.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.97 / $265.97 / $265.97	Facility		$265.97	$265.97	$265.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $226.07 / $226.07 / $452.63	Professional		$226.07	$226.07	$452.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $378.12 / $378.12 / $378.12	Facility		$378.12	$378.12	$378.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $378.12 / $378.12 / $378.12	Professional		$378.12	$378.12	$378.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $387.68 / $426.44	Professional		$75.00	$387.68	$426.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $378.12 / $411.19 / $495.85	Facility		$378.12	$411.19	$495.85
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $340.31 / $411.19 / $495.85	Professional		$340.31	$411.19	$495.85
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.57 / $355.72 / $513.95	Facility		$35.57	$355.72	$513.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.20 / $312.04 / $717.15	Professional		$31.20	$312.04	$717.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $367.11 / $367.11 / $367.11	Facility		$367.11	$367.11	$367.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $34.15 / $41.58	Professional		$34.15	$34.15	$41.58
United Facility/Professional Professional Modifier Low / Median / High Price $201.72 / $230.04 / $387.65	Professional		$201.72	$230.04	$387.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $374.32 / $374.32 / $374.32	Professional		$374.32	$374.32	$374.32