Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.47 / $281.25 / $13,750.00	Facility		$120.47	$281.25	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.86 / $120.47 / $295.93	Professional		$57.86	$120.47	$295.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $165.43 / $979.03	Facility		$55.00	$165.43	$979.03
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $135.36 / $251.06 / $885.44	Professional		$135.36	$251.06	$885.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $1,110.00	Facility		$644.92	$1,110.00	$1,110.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.71 / $183.88 / $314.72	Professional		$118.71	$183.88	$314.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $123.54 / $187.54 / $283.12	Facility		$123.54	$187.54	$283.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.80 / $193.36 / $296.37	Professional		$127.80	$193.36	$296.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $150.24 / $264.34	Professional		$26.42	$150.24	$264.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $149.10 / $231.21 / $242.54	Facility		$149.10	$231.21	$242.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $161.72 / $161.72 / $165.43	Facility		$161.72	$161.72	$165.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.80 / $226.07 / $303.25	Professional		$136.80	$226.07	$303.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $777.11 / $777.11 / $979.03	Facility		$777.11	$777.11	$979.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.66 / $187.34 / $295.99	Professional		$131.66	$187.34	$295.99
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $648.00 / $5,793.00	Facility		$140.00	$648.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $143.01 / $188.90 / $347.57	Professional		$143.01	$188.90	$347.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.59 / $99.59 / $128.79	Professional		$99.59	$99.59	$128.79