Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.72 / $271.31 / $626.02	Professional		$269.72	$271.31	$626.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $476.19 / $2,574.69 / $2,574.69	Facility		$476.19	$2,574.69	$2,574.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $53.85 / $437.28 / $656.04	Professional		$53.85	$437.28	$656.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $358.71 / $358.71 / $358.71	Facility		$358.71	$358.71	$358.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.89 / $358.71 / $470.81	Professional		$304.89	$358.71	$470.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $513.59 / $513.59 / $513.59	Facility		$513.59	$513.59	$513.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $513.59 / $513.59 / $513.59	Professional		$513.59	$513.59	$513.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.38 / $452.83 / $603.73	Professional		$60.38	$452.83	$603.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $513.59 / $539.42 / $654.85	Facility		$513.59	$539.42	$654.85
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $513.59 / $539.42 / $654.85	Professional		$513.59	$539.42	$654.85
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.62 / $476.19 / $573.41	Facility		$47.62	$476.19	$573.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.38 / $423.84 / $498.63	Professional		$42.38	$423.84	$498.63
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $498.63 / $498.63 / $498.63	Facility		$498.63	$498.63	$498.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $44.23 / $44.23 / $53.85	Professional		$44.23	$44.23	$53.85
United Facility/Professional Facility Modifier Low / Median / High Price $27.00 / $219.76 / $329.51	Facility		$27.00	$219.76	$329.51
United Facility/Professional Professional Modifier Low / Median / High Price $270.02 / $297.97 / $518.95	Professional		$270.02	$297.97	$518.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $466.91 / $466.91 / $466.91	Professional		$466.91	$466.91	$466.91