Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.18 / $231.64 / $428.42	Professional		$192.18	$231.64	$428.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $33.74 / $1,807.28 / $1,807.28	Facility		$33.74	$1,807.28	$1,807.28
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $230.79 / $296.27 / $413.23	Professional		$230.79	$296.27	$413.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $267.62 / $267.62 / $330.59	Facility		$267.62	$267.62	$330.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.48 / $267.62 / $330.59	Professional		$227.48	$267.62	$330.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $384.65 / $384.65 / $384.65	Facility		$384.65	$384.65	$384.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $384.65 / $384.65 / $384.65	Professional		$384.65	$384.65	$384.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $308.52 / $339.37	Professional		$75.00	$308.52	$339.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $383.23 / $384.65 / $411.72	Facility		$383.23	$384.65	$411.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $384.65 / $384.65 / $411.72	Professional		$384.65	$384.65	$411.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.74 / $33.74 / $429.47	Facility		$33.74	$33.74	$429.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.75 / $317.43 / $386.07	Professional		$31.75	$317.43	$386.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $373.45 / $373.45 / $373.45	Facility		$373.45	$373.45	$373.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $27.18 / $27.18 / $33.09	Professional		$27.18	$27.18	$33.09
United Facility/Professional Professional Modifier Low / Median / High Price $183.07 / $191.23 / $367.69	Professional		$183.07	$191.23	$367.69