Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.35 / $488.12 / $1,028.28	Facility		$147.35	$488.12	$1,028.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.73 / $147.35 / $152.05	Professional		$109.73	$147.35	$152.05
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $250.80 / $744.56	Facility		$164.59	$250.80	$744.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $141.08 / $325.93 / $1,175.63	Professional		$141.08	$325.93	$1,175.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.02 / $333.21 / $404.76	Facility		$163.02	$333.21	$404.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $141.08 / $156.75 / $266.48	Facility		$141.08	$156.75	$266.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.08 / $156.75 / $391.88	Professional		$141.08	$156.75	$391.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.08 / $172.43 / $274.31	Facility		$141.08	$172.43	$274.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $156.75 / $274.31 / $485.93	Facility		$156.75	$274.31	$485.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.08 / $195.94 / $236.69	Professional		$141.08	$195.94	$236.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $250.80 / $431.06	Facility		$164.59	$250.80	$431.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.37 / $289.56 / $384.29	Professional		$173.37	$289.56	$384.29
United Facility/Professional Facility Modifier Low / Median / High Price $156.75 / $188.10 / $188.10	Facility		$156.75	$188.10	$188.10
United Facility/Professional Professional Modifier Low / Median / High Price $65.84 / $65.84 / $175.56	Professional		$65.84	$65.84	$175.56