Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.16 / $98.64 / $166.14	Professional		$72.16	$98.64	$166.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $955.82 / $955.82	Facility		$100.00	$955.82	$955.82
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $20.70 / $152.99 / $206.46	Professional		$20.70	$152.99	$206.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.00 / $112.73 / $112.73	Facility		$112.00	$112.73	$112.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $95.82 / $173.88	Professional		$16.55	$95.82	$173.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $182.20 / $182.20 / $182.20	Facility		$182.20	$182.20	$182.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $182.20 / $182.20 / $182.20	Professional		$182.20	$182.20	$182.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $154.32 / $192.91 / $212.20	Professional		$154.32	$192.91	$212.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $212.80 / $279.95 / $341.03	Facility		$212.80	$279.95	$341.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $279.95 / $341.03 / $341.03	Professional		$279.95	$341.03	$341.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.32 / $17.32 / $17.32	Facility		$17.32	$17.32	$17.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.04 / $150.37 / $203.44	Professional		$15.04	$150.37	$203.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $17.00 / $20.70	Professional		$17.00	$17.00	$20.70
United Facility/Professional Professional Modifier Low / Median / High Price $84.23 / $98.27 / $140.38	Professional		$84.23	$98.27	$140.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $149.97 / $149.97 / $149.97	Professional		$149.97	$149.97	$149.97