Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.75 / $343.47 / $18,711.00	Facility		$174.75	$343.47	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.70 / $142.49 / $307.45	Professional		$83.70	$142.49	$307.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $140.49 / $1,104.92 / $2,161.55	Facility		$140.49	$1,104.92	$2,161.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $136.86 / $335.19 / $1,348.48	Professional		$136.86	$335.19	$1,348.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.88 / $270.45 / $421.10	Facility		$177.88	$270.45	$421.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.82 / $237.38 / $482.81	Professional		$125.82	$237.38	$482.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.50 / $231.42 / $439.00	Facility		$138.50	$231.42	$439.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.83 / $240.69 / $440.23	Professional		$138.83	$240.69	$440.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.11 / $300.91 / $533.54	Professional		$54.11	$300.91	$533.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $163.31 / $241.43 / $355.10	Facility		$163.31	$241.43	$355.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.16 / $245.98 / $248.61	Facility		$113.16	$245.98	$248.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $248.61 / $455.71	Professional		$134.88	$248.61	$455.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $732.75 / $1,129.34 / $2,161.55	Facility		$732.75	$1,129.34	$2,161.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $129.82 / $245.77 / $421.06	Professional		$129.82	$245.77	$421.06
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $588.00 / $5,793.00	Facility		$140.00	$588.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $138.71 / $242.42 / $526.21	Professional		$138.71	$242.42	$526.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.11 / $101.11 / $200.95	Professional		$101.11	$101.11	$200.95