Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.44 / $274.18 / $625.01	Professional		$226.44	$274.18	$625.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,544.80 / $2,544.80	Facility		$100.00	$2,544.80	$2,544.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $56.91 / $430.75 / $669.76	Professional		$56.91	$430.75	$669.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $354.55 / $354.55 / $465.35	Facility		$354.55	$354.55	$465.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.37 / $354.55 / $465.35	Professional		$301.37	$354.55	$465.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $508.78 / $508.78 / $508.78	Facility		$508.78	$508.78	$508.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $508.78 / $508.78 / $508.78	Professional		$508.78	$508.78	$508.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $478.47 / $583.67	Professional		$75.00	$478.47	$583.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $508.78 / $525.64 / $675.93	Facility		$508.78	$525.64	$675.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $508.78 / $508.78 / $637.87	Professional		$508.78	$508.78	$637.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.12 / $48.12 / $568.04	Facility		$48.12	$48.12	$568.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.99 / $419.87 / $574.76	Professional		$41.99	$419.87	$574.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $493.96 / $493.96 / $493.96	Facility		$493.96	$493.96	$493.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.74 / $46.74 / $56.91	Professional		$46.74	$46.74	$56.91
United Facility/Professional Professional Modifier Low / Median / High Price $272.36 / $314.86 / $523.38	Professional		$272.36	$314.86	$523.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $493.38 / $493.38 / $493.38	Professional		$493.38	$493.38	$493.38