Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.09 / $576.71 / $1,214.91	Facility		$174.09	$576.71	$1,214.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.68 / $174.09 / $179.64	Professional		$116.68	$174.09	$179.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $194.46 / $296.32 / $648.20	Facility		$194.46	$296.32	$648.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $379.26 / $1,389.00	Professional		$185.20	$379.26	$1,389.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.61 / $393.68 / $478.21	Facility		$192.61	$393.68	$478.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $166.68 / $185.20 / $463.00	Facility		$166.68	$185.20	$463.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $166.68 / $185.20 / $463.00	Professional		$166.68	$185.20	$463.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $185.20 / $259.27	Facility		$185.20	$185.20	$259.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $324.10 / $555.60	Facility		$185.20	$324.10	$555.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.68 / $231.50 / $279.64	Professional		$166.68	$231.50	$279.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $194.46 / $296.32 / $509.30	Facility		$194.46	$296.32	$509.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.83 / $360.30 / $430.34	Professional		$204.83	$360.30	$430.34
United Facility/Professional Professional Modifier Low / Median / High Price $77.78 / $77.78 / $207.42	Professional		$77.78	$77.78	$207.42