Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.20 / $216.99 / $496.90	Professional		$178.20	$216.99	$496.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,990.31 / $1,990.31	Facility		$100.00	$1,990.31	$1,990.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $247.81 / $338.03 / $527.29	Professional		$247.81	$338.03	$527.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $277.51 / $277.51 / $371.51	Facility		$277.51	$277.51	$371.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.88 / $277.51 / $371.51	Professional		$235.88	$277.51	$371.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $403.72 / $403.72 / $403.72	Facility		$403.72	$403.72	$403.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $403.72 / $403.72 / $403.72	Professional		$403.72	$403.72	$403.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $417.57 / $459.32	Professional		$75.00	$417.57	$459.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $403.72 / $419.80 / $531.91	Facility		$403.72	$419.80	$531.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $403.72 / $419.80 / $502.18	Professional		$403.72	$419.80	$502.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.09 / $38.09 / $450.77	Facility		$38.09	$38.09	$450.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.32 / $333.17 / $391.97	Professional		$33.32	$333.17	$391.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $391.97 / $391.97 / $391.97	Facility		$391.97	$391.97	$391.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.79 / $36.79 / $44.80	Professional		$36.79	$36.79	$44.80
United Facility/Professional Professional Modifier Low / Median / High Price $215.97 / $242.22 / $412.98	Professional		$215.97	$242.22	$412.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $388.27 / $388.27 / $388.27	Professional		$388.27	$388.27	$388.27