Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.93 / $499.35 / $13,750.00	Facility		$225.93	$499.35	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.34 / $173.30 / $458.06	Professional		$105.34	$173.30	$458.06
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $271.92 / $1,993.85 / $5,158.68	Facility		$271.92	$1,993.85	$5,158.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $171.84 / $379.61 / $1,469.12	Professional		$171.84	$379.61	$1,469.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.10 / $421.10 / $731.00	Facility		$205.10	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.06 / $264.86 / $528.41	Professional		$153.06	$264.86	$528.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $160.08 / $268.50 / $489.85	Facility		$160.08	$268.50	$489.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.50 / $283.10 / $480.64	Professional		$165.50	$283.10	$480.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.53 / $245.57 / $464.54	Professional		$46.53	$245.57	$464.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $192.44 / $286.24 / $397.19	Facility		$192.44	$286.24	$397.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.20 / $267.72 / $271.92	Facility		$122.20	$267.72	$271.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.96 / $299.54 / $498.11	Professional		$172.96	$299.54	$498.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,454.88 / $1,992.71 / $3,814.01	Facility		$1,454.88	$1,992.71	$3,814.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.40 / $273.04 / $460.53	Professional		$165.40	$273.04	$460.53
United Facility/Professional Facility Modifier Low / Median / High Price $350.00 / $887.00 / $4,611.00	Facility		$350.00	$887.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $230.01 / $279.08 / $564.29	Professional		$230.01	$279.08	$564.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $133.79 / $133.79 / $221.40	Professional		$133.79	$133.79	$221.40