Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.30 / $444.80 / $13,750.00	Facility		$211.30	$444.80	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.92 / $182.55 / $377.97	Professional		$121.92	$182.55	$377.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $97.93 / $2,141.39 / $4,357.93	Facility		$97.93	$2,141.39	$4,357.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $211.08 / $368.53 / $1,322.40	Professional		$211.08	$368.53	$1,322.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.93 / $126.93 / $211.47	Facility		$126.93	$126.93	$211.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.71 / $311.62 / $538.20	Professional		$185.71	$311.62	$538.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $144.15 / $269.83 / $555.92	Facility		$144.15	$269.83	$555.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.80 / $264.00 / $393.58	Professional		$148.80	$264.00	$393.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $278.79 / $453.80	Professional		$42.97	$278.79	$453.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $207.64 / $300.16 / $360.46	Facility		$207.64	$300.16	$360.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.93 / $240.09 / $245.87	Facility		$97.93	$240.09	$245.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.77 / $309.19 / $450.68	Professional		$209.77	$309.19	$450.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,477.31 / $2,250.40 / $4,357.93	Facility		$1,477.31	$2,250.40	$4,357.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $194.40 / $283.42 / $416.41	Professional		$194.40	$283.42	$416.41
United Facility/Professional Facility Modifier Low / Median / High Price $591.00 / $1,106.00 / $4,911.00	Facility		$591.00	$1,106.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $207.01 / $349.40 / $515.58	Professional		$207.01	$349.40	$515.58