Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.96 / $593.88 / $13,750.00	Facility		$187.96	$593.88	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.29 / $204.04 / $589.00	Professional		$129.29	$204.04	$589.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $195.14 / $1,128.49 / $2,159.90	Facility		$195.14	$1,128.49	$2,159.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $159.51 / $288.43 / $1,236.45	Professional		$159.51	$288.43	$1,236.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.58 / $264.95 / $399.69	Professional		$148.58	$264.95	$399.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $212.85 / $321.39 / $512.91	Facility		$212.85	$321.39	$512.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $217.00 / $328.00 / $479.70	Professional		$217.00	$328.00	$479.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.02 / $200.83 / $356.53	Professional		$36.02	$200.83	$356.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $233.34 / $286.08 / $430.14	Facility		$233.34	$286.08	$430.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $191.62 / $191.62 / $195.14	Facility		$191.62	$191.62	$195.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.40 / $244.34 / $357.70	Professional		$146.40	$244.34	$357.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $732.19 / $1,128.49 / $2,159.90	Facility		$732.19	$1,128.49	$2,159.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $140.91 / $207.55 / $352.19	Professional		$140.91	$207.55	$352.19
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 $178.45 / $295.33 / $428.56	Professional		$178.45	$295.33	$428.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.36 / $107.36 / $152.75	Professional		$107.36	$107.36	$152.75