Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.80 / $349.80 / $349.80	Facility		$349.80	$349.80	$349.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $346.62 / $349.80	Professional		$318.00	$346.62	$349.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $318.00 / $1,273.03 / $2,027.14	Facility		$318.00	$1,273.03	$2,027.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $330.72 / $2,162.28	Professional		$318.00	$330.72	$2,162.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $300.00 / $547.02	Facility		$300.00	$300.00	$547.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $318.00 / $390.00	Professional		$318.00	$318.00	$390.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $318.00 / $318.00 / $429.30	Facility		$318.00	$318.00	$429.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $318.00 / $429.30	Professional		$318.00	$318.00	$429.30
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 $318.00 / $345.00 / $661.44	Facility		$318.00	$345.00	$661.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $559.79 / $1,203.50 / $1,203.50	Facility		$559.79	$1,203.50	$1,203.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $402.35 / $454.83 / $717.23	Professional		$402.35	$454.83	$717.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $318.00 / $318.00 / $318.00	Facility		$318.00	$318.00	$318.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $302.10 / $318.00 / $318.00	Professional		$302.10	$318.00	$318.00
United Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $318.00 / $381.60	Professional		$318.00	$318.00	$381.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $318.00 / $370.86	Professional		$318.00	$318.00	$370.86