Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $209.33 / $478.72 / $13,750.00	Facility		$209.33	$478.72	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.51 / $164.36 / $384.74	Professional		$106.51	$164.36	$384.74
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $186.83 / $1,836.95 / $3,748.81	Facility		$186.83	$1,836.95	$3,748.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $194.01 / $314.86 / $1,176.08	Professional		$194.01	$314.86	$1,176.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $198.44 / $765.00 / $870.49	Facility		$198.44	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.02 / $245.63 / $450.77	Professional		$143.02	$245.63	$450.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $128.69 / $227.26 / $376.85	Facility		$128.69	$227.26	$376.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $226.66 / $364.05	Professional		$128.69	$226.66	$364.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.55 / $293.43 / $518.57	Professional		$51.55	$293.43	$518.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $193.30 / $285.42 / $326.29	Facility		$193.30	$285.42	$326.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.22 / $213.36 / $222.56	Facility		$62.22	$213.36	$222.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.61 / $285.23 / $398.41	Professional		$191.61	$285.23	$398.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,270.82 / $1,958.65 / $3,748.81	Facility		$1,270.82	$1,958.65	$3,748.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $184.96 / $258.43 / $381.98	Professional		$184.96	$258.43	$381.98
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 $189.64 / $255.79 / $461.51	Professional		$189.64	$255.79	$461.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $122.67 / $134.99 / $176.73	Professional		$122.67	$134.99	$176.73