Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.13 / $167.09 / $366.01	Professional		$137.13	$167.09	$366.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,464.56 / $1,464.56	Facility		$100.00	$1,464.56	$1,464.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $183.90 / $247.24 / $395.41	Professional		$183.90	$247.24	$395.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.05 / $204.05 / $273.18	Facility		$204.05	$204.05	$273.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.44 / $173.44 / $349.88	Professional		$173.44	$173.44	$349.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $310.97 / $310.97 / $310.97	Facility		$310.97	$310.97	$310.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $310.97 / $310.97 / $310.97	Professional		$310.97	$310.97	$310.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $321.35 / $353.48	Professional		$75.00	$321.35	$353.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $303.16 / $310.97 / $409.35	Facility		$303.16	$310.97	$409.35
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $279.87 / $310.97 / $376.58	Professional		$279.87	$310.97	$376.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.32 / $29.32 / $347.20	Facility		$29.32	$29.32	$347.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.66 / $292.85 / $347.20	Professional		$25.66	$292.85	$347.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $301.91 / $301.91 / $301.91	Facility		$301.91	$301.91	$301.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.30 / $28.30 / $34.46	Professional		$28.30	$28.30	$34.46
United Facility/Professional Facility Modifier Low / Median / High Price $15.82 / $138.94 / $223.57	Facility		$15.82	$138.94	$223.57
United Facility/Professional Professional Modifier Low / Median / High Price $158.15 / $190.68 / $303.87	Professional		$158.15	$190.68	$303.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $303.87 / $303.87 / $303.87	Professional		$303.87	$303.87	$303.87