Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $264.29 / $954.50 / $13,809.00	Facility		$264.29	$954.50	$13,809.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.73 / $249.80 / $678.02	Professional		$124.73	$249.80	$678.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $327.52 / $1,949.61 / $3,814.01	Facility		$327.52	$1,949.61	$3,814.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $225.61 / $456.10 / $1,880.28	Professional		$225.61	$456.10	$1,880.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $375.43 / $500.00 / $568.48	Facility		$375.43	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.07 / $349.03 / $680.03	Professional		$172.07	$349.03	$680.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $163.81 / $318.02 / $635.54	Facility		$163.81	$318.02	$635.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $163.81 / $318.02 / $609.07	Professional		$163.81	$318.02	$609.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.72 / $332.98 / $589.28	Professional		$58.72	$332.98	$589.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $257.95 / $466.99 / $497.14	Facility		$257.95	$466.99	$497.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.95 / $327.52 / $378.19	Facility		$125.95	$327.52	$378.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $220.80 / $348.04 / $599.29	Professional		$220.80	$348.04	$599.29
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 $202.13 / $334.03 / $594.13	Professional		$202.13	$334.03	$594.13
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $295.74 / $399.85 / $718.46	Professional		$295.74	$399.85	$718.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.76 / $196.28 / $266.70	Professional		$144.76	$196.28	$266.70