Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $596.32 / $596.32 / $596.32	Facility		$596.32	$596.32	$596.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.97 / $589.73 / $954.97	Professional		$259.97	$589.73	$954.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $846.11 / $1,215.26 / $2,065.41	Facility		$846.11	$1,215.26	$2,065.41
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $95.17 / $171.97 / $846.11	Professional		$95.17	$171.97	$846.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $475.81 / $1,803.56 / $2,274.48	Facility		$475.81	$1,803.56	$2,274.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.73 / $128.57 / $216.53	Professional		$72.73	$128.57	$216.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $53.60 / $130.74 / $839.35	Facility		$53.60	$130.74	$839.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $106.42 / $187.74	Professional		$48.28	$106.42	$187.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.87 / $56.19 / $80.86	Professional		$13.87	$56.19	$80.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $20.39 / $25.17 / $26.81	Facility		$20.39	$25.17	$26.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.23 / $93.23 / $93.32	Facility		$93.23	$93.23	$93.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.37 / $160.43 / $194.21	Professional		$107.37	$160.43	$194.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $936.81 / $1,524.33 / $2,973.07	Facility		$936.81	$1,524.33	$2,973.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.17 / $141.16 / $193.99	Professional		$95.17	$141.16	$193.99
United Facility/Professional Professional Modifier Low / Median / High Price $109.89 / $559.36 / $1,582.62	Professional		$109.89	$559.36	$1,582.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.52 / $28.52	Professional		$28.52	$28.52	$28.52