Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.63 / $264.39 / $525.50	Facility		$135.63	$264.39	$525.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.08 / $135.63 / $392.76	Professional		$113.08	$135.63	$392.76
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 $152.00 / $248.05 / $1,031.53	Professional		$152.00	$248.05	$1,031.53
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 $147.90 / $250.32 / $380.41	Professional		$147.90	$250.32	$380.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $127.10 / $290.77 / $1,678.39	Facility		$127.10	$290.77	$1,678.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.10 / $274.73 / $362.83	Professional		$127.10	$274.73	$362.83
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 $180.34 / $219.76 / $301.72	Facility		$180.34	$219.76	$301.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $245.84 / $245.84 / $273.14	Professional		$245.84	$245.84	$273.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $149.04 / $149.04 / $149.90	Facility		$149.04	$149.04	$149.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.47 / $250.03 / $307.43	Professional		$167.47	$250.03	$307.43
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 $152.00 / $226.98 / $307.80	Professional		$152.00	$226.98	$307.80
United Facility/Professional Professional Modifier Low / Median / High Price $97.86 / $125.38 / $309.69	Professional		$97.86	$125.38	$309.69