Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.82 / $297.12 / $858.25	Facility		$165.82	$297.12	$858.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.93 / $148.94 / $308.08	Professional		$98.93	$148.94	$308.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $134.87 / $713.37 / $1,455.83	Facility		$134.87	$713.37	$1,455.83
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $862.23 / $1,141.58 / $2,208.54	Facility	50	$862.23	$1,141.58	$2,208.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $167.17 / $259.76 / $966.32	Professional		$167.17	$259.76	$966.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.87 / $147.87 / $147.87	Facility		$147.87	$147.87	$147.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.59 / $211.00 / $361.48	Professional		$122.59	$211.00	$361.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $110.80 / $205.76 / $328.42	Facility		$110.80	$205.76	$328.42
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $640.16 / $839.51 / $2,019.86	Facility	50	$640.16	$839.51	$2,019.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $110.80 / $198.40 / $315.58	Professional		$110.80	$198.40	$315.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.39 / $202.16 / $356.23	Professional		$36.39	$202.16	$356.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $180.81 / $249.24 / $259.95	Facility		$180.81	$249.24	$259.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.91 / $170.78 / $177.32	Facility		$44.91	$170.78	$177.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.17 / $231.99 / $318.39	Professional		$165.17	$231.99	$318.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $550.49 / $761.06 / $1,455.83	Facility		$550.49	$761.06	$1,455.83
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $825.74 / $1,141.58 / $2,183.75	Facility	50	$825.74	$1,141.58	$2,183.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $217.84 / $311.70	Professional		$142.63	$217.84	$311.70
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $154.99 / $211.12 / $368.82	Professional		$154.99	$211.12	$368.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.09 / $107.39 / $141.18	Professional		$104.09	$107.39	$141.18