Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $391.46 / $391.46 / $391.46	Facility		$391.46	$391.46	$391.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.88 / $391.46 / $391.46	Professional		$355.88	$391.46	$391.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $398.40 / $456.00 / $1,800.00	Facility		$398.40	$456.00	$1,800.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $408.00 / $1,824.00 / $2,160.00	Professional		$408.00	$1,824.00	$2,160.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $408.00 / $816.00	Facility		$408.00	$408.00	$816.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Professional		$408.00	$408.00	$408.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12.79 / $12.79 / $12.79	Professional		$12.79	$12.79	$12.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $355.88 / $355.88 / $79,999.20	Facility		$355.88	$355.88	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.40 / $398.40 / $408.00	Facility		$398.40	$398.40	$408.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $369.60 / $408.00 / $432.00	Professional		$369.60	$408.00	$432.00
United Facility/Professional Professional Modifier Low / Median / High Price $480.00 / $480.00 / $576.00	Professional		$480.00	$480.00	$576.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $355.88 / $355.88 / $355.88	Professional		$355.88	$355.88	$355.88