Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $387.32 / $797.80 / $13,750.00	Facility		$387.32	$797.80	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.65 / $267.52 / $551.29	Professional		$170.65	$267.52	$551.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $407.19 / $4,591.92 / $9,102.00	Facility		$407.19	$4,591.92	$9,102.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $288.35 / $587.69 / $2,205.67	Professional		$288.35	$587.69	$2,205.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $271.11 / $412.19 / $644.92	Facility		$271.11	$412.19	$644.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.44 / $425.60 / $787.92	Professional		$266.44	$425.60	$787.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $266.60 / $445.56 / $757.23	Facility		$266.60	$445.56	$757.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $268.22 / $451.40 / $711.65	Professional		$268.22	$451.40	$711.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $208.24 / $580.82	Professional		$34.96	$208.24	$580.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $259.77 / $486.21 / $596.97	Facility		$259.77	$486.21	$596.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $167.07 / $398.19 / $407.19	Facility		$167.07	$398.19	$407.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.75 / $493.43 / $746.39	Professional		$293.75	$493.43	$746.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,979.36 / $4,591.92 / $8,788.86	Facility		$2,979.36	$4,591.92	$8,788.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $282.27 / $415.79 / $689.63	Professional		$282.27	$415.79	$689.63
United Facility/Professional Facility Modifier Low / Median / High Price $350.00 / $910.00 / $4,611.00	Facility		$350.00	$910.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $340.80 / $443.04 / $855.82	Professional		$340.80	$443.04	$855.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $226.06 / $226.06 / $328.27	Professional		$226.06	$226.06	$328.27