Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $383.92 / $383.92 / $383.92	Facility		$383.92	$383.92	$383.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.02 / $383.92 / $388.64	Professional		$349.02	$383.92	$388.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $349.02 / $688.50 / $1,423.99	Facility		$349.02	$688.50	$1,423.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $349.02 / $349.02 / $2,835.00	Professional		$349.02	$349.02	$2,835.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.26 / $329.26 / $721.02	Facility		$329.26	$329.26	$721.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.01 / $349.01 / $428.04	Professional		$349.01	$349.01	$428.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $349.02 / $349.02 / $471.18	Facility		$349.02	$349.02	$471.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $349.02 / $349.02 / $471.18	Professional		$349.02	$349.02	$471.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $349.01 / $356.55 / $659.65	Facility		$349.01	$356.55	$659.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $672.30 / $672.30 / $688.50	Facility		$672.30	$672.30	$688.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $623.70 / $688.50 / $729.00	Professional		$623.70	$688.50	$729.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $349.02 / $349.02 / $349.02	Facility		$349.02	$349.02	$349.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $331.57 / $349.02 / $349.02	Professional		$331.57	$349.02	$349.02
United Facility/Professional Professional Modifier Low / Median / High Price $349.02 / $349.02 / $418.82	Professional		$349.02	$349.02	$418.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $343.51 / $349.02 / $349.02	Professional		$343.51	$349.02	$349.02