Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.25 / $541.17 / $13,750.00	Facility		$174.25	$541.17	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.95 / $207.63 / $509.31	Professional		$87.95	$207.63	$509.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $663.60 / $2,583.03 / $11,500.00	Facility		$663.60	$2,583.03	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $155.88 / $323.86 / $2,489.00	Professional		$155.88	$323.86	$2,489.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,132.06	Facility		$466.83	$568.48	$1,132.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.17 / $248.28 / $647.99	Professional		$116.17	$248.28	$647.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $119.08 / $244.36 / $840.73	Facility		$119.08	$244.36	$840.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.08 / $238.40 / $687.71	Professional		$119.08	$238.40	$687.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.76 / $354.08 / $625.40	Professional		$62.76	$354.08	$625.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $204.36 / $367.76 / $459.62	Facility		$204.36	$367.76	$459.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $308.82 / $313.50 / $927.31	Facility		$308.82	$313.50	$927.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.51 / $285.52 / $576.78	Professional		$155.51	$285.52	$576.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,674.98 / $2,581.55 / $4,941.05	Facility		$1,674.98	$2,581.55	$4,941.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $150.78 / $303.27 / $549.74	Professional		$150.78	$303.27	$549.74
United Facility/Professional Facility Modifier Low / Median / High Price $938.00 / $3,184.20 / $5,093.20	Facility		$938.00	$3,184.20	$5,093.20
United Facility/Professional Professional Modifier Low / Median / High Price $249.06 / $354.96 / $657.40	Professional		$249.06	$354.96	$657.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.13 / $184.69 / $253.06	Professional		$101.13	$184.69	$253.06