Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.19 / $133.00 / $303.26	Professional		$114.19	$133.00	$303.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,154.28 / $1,154.28	Facility		$100.00	$1,154.28	$1,154.28
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $195.51 / $322.42	Professional		$28.70	$195.51	$322.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.96 / $160.96 / $215.49	Facility		$160.96	$160.96	$215.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.82 / $160.96 / $215.49	Professional		$136.82	$160.96	$215.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $242.31 / $242.31 / $242.31	Facility		$242.31	$242.31	$242.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $242.31 / $242.31 / $242.31	Professional		$242.31	$242.31	$242.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $267.58 / $294.33	Professional		$75.00	$267.58	$294.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $242.31 / $250.59 / $340.87	Facility		$242.31	$250.59	$340.87
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $218.08 / $250.59 / $307.07	Professional		$218.08	$250.59	$307.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.34 / $233.43 / $233.43	Facility		$23.34	$233.43	$233.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $27.06 / $270.55	Professional		$20.00	$27.06	$270.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $235.26 / $235.26 / $235.26	Facility		$235.26	$235.26	$235.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $23.57 / $23.57 / $28.70	Professional		$23.57	$23.57	$28.70
United Facility/Professional Professional Modifier Low / Median / High Price $125.95 / $158.78 / $241.97	Professional		$125.95	$158.78	$241.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $253.74 / $253.74 / $253.74	Professional		$253.74	$253.74	$253.74