Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.47 / $248.76 / $616.46	Facility		$155.47	$248.76	$616.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.37 / $155.47 / $237.02	Professional		$121.37	$155.47	$237.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $233.98 / $352.91 / $1,190.96	Facility		$233.98	$352.91	$1,190.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $180.64 / $306.20 / $1,104.53	Professional		$180.64	$306.20	$1,104.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.27 / $307.94 / $543.54	Facility		$139.27	$307.94	$543.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $276.45 / $422.44	Professional		$175.40	$276.45	$422.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $122.34 / $290.20 / $436.87	Facility		$122.34	$290.20	$436.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.18 / $298.77 / $428.62	Professional		$148.18	$298.77	$428.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $65.00	Professional		$45.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $201.84 / $242.22 / $273.70	Facility		$201.84	$242.22	$273.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.20 / $173.20 / $177.12	Facility		$173.20	$173.20	$177.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.98 / $293.70 / $355.24	Professional		$198.98	$293.70	$355.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $233.85 / $331.60 / $646.22	Facility		$233.85	$331.60	$646.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $180.64 / $262.27 / $365.57	Professional		$180.64	$262.27	$365.57
United Facility/Professional Facility Modifier Low / Median / High Price $83.10 / $83.10 / $83.10	Facility		$83.10	$83.10	$83.10
United Facility/Professional Professional Modifier Low / Median / High Price $151.24 / $179.55 / $351.90	Professional		$151.24	$179.55	$351.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $160.91 / $160.91	Professional		$160.91	$160.91	$160.91