Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.91 / $299.86 / $638.59	Facility		$152.91	$299.86	$638.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.51 / $152.91 / $445.44	Professional		$128.51	$152.91	$445.44
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $737.25 / $1,168.81 / $2,235.80	Facility		$737.25	$1,168.81	$2,235.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $171.40 / $290.62 / $906.00	Professional		$171.40	$290.62	$906.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $513.41 / $780.44 / $1,926.24	Facility		$513.41	$780.44	$1,926.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.00 / $283.88 / $432.14	Professional		$179.00	$283.88	$432.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $151.59 / $331.82 / $1,678.39	Facility		$151.59	$331.82	$1,678.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.59 / $322.42 / $405.00	Professional		$151.59	$322.42	$405.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.78 / $144.45 / $301.99	Professional		$29.78	$144.45	$301.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $204.60 / $249.24 / $327.63	Facility		$204.60	$249.24	$327.63
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $273.14 / $273.14 / $273.14	Professional		$273.14	$273.14	$273.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.06 / $168.06 / $170.00	Facility		$168.06	$168.06	$170.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.56 / $283.58 / $348.68	Professional		$189.56	$283.58	$348.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $757.92 / $1,142.86 / $2,222.71	Facility		$757.92	$1,142.86	$2,222.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $171.40 / $257.42 / $366.04	Professional		$171.40	$257.42	$366.04
United Facility/Professional Facility Modifier Low / Median / High Price $16.30 / $68.15 / $84.45	Facility		$16.30	$68.15	$84.45
United Facility/Professional Professional Modifier Low / Median / High Price $110.13 / $148.60 / $350.54	Professional		$110.13	$148.60	$350.54