Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.85 / $189.73 / $443.87	Professional		$154.85	$189.73	$443.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,744.00 / $1,744.00	Facility		$100.00	$1,744.00	$1,744.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $38.93 / $296.26 / $460.05	Professional		$38.93	$296.26	$460.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.17 / $243.17 / $319.16	Facility		$243.17	$243.17	$319.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.69 / $243.17 / $319.16	Professional		$206.69	$243.17	$319.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $344.75 / $344.75 / $344.75	Facility		$344.75	$344.75	$344.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $344.75 / $344.75 / $344.75	Professional		$344.75	$344.75	$344.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $362.85 / $399.13	Professional		$75.00	$362.85	$399.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $344.75 / $379.46 / $462.23	Facility		$344.75	$379.46	$462.23
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $310.27 / $379.46 / $438.14	Professional		$310.27	$379.46	$438.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.70 / $32.70 / $468.59	Facility		$32.70	$32.70	$468.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $324.67 / $384.92	Professional		$28.45	$324.67	$384.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $334.71 / $334.71 / $334.71	Facility		$334.71	$334.71	$334.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $31.97 / $38.93	Professional		$31.97	$31.97	$38.93
United Facility/Professional Professional Modifier Low / Median / High Price $185.44 / $215.30 / $356.34	Professional		$185.44	$215.30	$356.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $337.38 / $337.38 / $337.38	Professional		$337.38	$337.38	$337.38