Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.46 / $195.77 / $444.26	Professional		$166.46	$195.77	$444.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $347.89 / $1,749.66 / $1,749.66	Facility		$347.89	$1,749.66	$1,749.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $295.08 / $476.20	Professional		$41.84	$295.08	$476.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.78 / $243.78 / $326.36	Facility		$243.78	$243.78	$326.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.21 / $243.78 / $326.36	Professional		$207.21	$243.78	$326.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $358.33 / $358.33 / $358.33	Facility		$358.33	$358.33	$358.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $358.33 / $358.33 / $358.33	Professional		$358.33	$358.33	$358.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.89 / $351.73 / $469.01	Professional		$46.89	$351.73	$469.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $358.33 / $367.94 / $496.91	Facility		$358.33	$367.94	$496.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $340.41 / $367.94 / $434.28	Professional		$340.41	$367.94	$434.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $343.58 / $343.58 / $487.05	Facility		$343.58	$343.58	$487.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.57 / $295.70 / $347.89	Professional		$29.57	$295.70	$347.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $347.89 / $347.89 / $347.89	Facility		$347.89	$347.89	$347.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $34.36 / $41.84	Professional		$34.36	$34.36	$41.84
United Facility/Professional Professional Modifier Low / Median / High Price $187.15 / $231.47 / $359.56	Professional		$187.15	$231.47	$359.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $362.71 / $362.71 / $362.71	Professional		$362.71	$362.71	$362.71