Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.78 / $243.20 / $563.65	Professional		$215.78	$243.20	$563.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $423.16 / $2,147.32 / $2,147.32	Facility		$423.16	$2,147.32	$2,147.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $270.70 / $363.54 / $604.92	Professional		$270.70	$363.54	$604.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $299.44 / $299.44 / $400.87	Facility		$299.44	$299.44	$400.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.52 / $299.44 / $400.87	Professional		$254.52	$299.44	$400.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $435.85 / $435.85 / $435.85	Facility		$435.85	$435.85	$435.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $435.85 / $435.85 / $435.85	Professional		$435.85	$435.85	$435.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $505.62 / $556.18	Professional		$75.00	$505.62	$556.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $435.85 / $462.11 / $644.08	Facility		$435.85	$462.11	$644.08
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $392.27 / $462.11 / $644.08	Professional		$392.27	$462.11	$644.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.68 / $42.68 / $592.41	Facility		$42.68	$42.68	$592.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $410.47 / $547.70	Professional		$35.97	$410.47	$547.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $423.16 / $423.16 / $423.16	Facility		$423.16	$423.16	$423.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $44.54 / $44.54 / $54.23	Professional		$44.54	$44.54	$54.23
United Facility/Professional Professional Modifier Low / Median / High Price $235.28 / $300.04 / $451.97	Professional		$235.28	$300.04	$451.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $470.15 / $470.15 / $470.15	Professional		$470.15	$470.15	$470.15