Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $609.33 / $609.33 / $609.33	Facility		$609.33	$609.33	$609.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $553.94 / $570.54 / $609.33	Professional		$553.94	$570.54	$609.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $553.94 / $1,062.50 / $2,500.00	Facility		$553.94	$1,062.50	$2,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $385.11 / $553.94 / $5,000.00	Professional		$385.11	$553.94	$5,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $495.84 / $522.58 / $553.94	Facility		$495.84	$522.58	$553.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $553.94 / $553.94 / $679.35	Professional		$553.94	$553.94	$679.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $553.94 / $553.94 / $747.82	Facility		$553.94	$553.94	$747.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $553.94 / $553.94 / $747.82	Professional		$553.94	$553.94	$747.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $75.00 / $75.00	Professional		$50.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $194.83 / $522.58 / $964.57	Facility		$194.83	$522.58	$964.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $385.11 / $1,037.50 / $1,037.50	Facility		$385.11	$1,037.50	$1,037.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.79 / $312.89 / $493.41	Professional		$276.79	$312.89	$493.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $553.94 / $553.94 / $553.94	Facility		$553.94	$553.94	$553.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $526.24 / $553.94 / $553.94	Professional		$526.24	$553.94	$553.94
United Facility/Professional Professional Modifier Low / Median / High Price $247.92 / $553.94 / $598.86	Professional		$247.92	$553.94	$598.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $255.14 / $553.92 / $553.92	Professional		$255.14	$553.92	$553.92