Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.91 / $252.06 / $489.57	Facility		$128.91	$252.06	$489.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.50 / $128.91 / $367.91	Professional		$107.50	$128.91	$367.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $737.25 / $1,168.14 / $2,235.80	Facility		$737.25	$1,168.14	$2,235.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $144.13 / $244.19 / $839.89	Professional		$144.13	$244.19	$839.89
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 $138.03 / $232.64 / $361.12	Professional		$138.03	$232.64	$361.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $121.52 / $272.07 / $1,678.39	Facility		$121.52	$272.07	$1,678.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.52 / $255.69 / $340.31	Professional		$121.52	$255.69	$340.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.49 / $108.67 / $285.19	Professional		$27.49	$108.67	$285.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $171.05 / $208.37 / $255.68	Facility		$171.05	$208.37	$255.68
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 $141.34 / $141.34 / $142.13	Facility		$141.34	$141.34	$142.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.25 / $237.08 / $291.50	Professional		$159.25	$237.08	$291.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $737.25 / $1,140.56 / $2,222.71	Facility		$737.25	$1,140.56	$2,222.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $144.13 / $215.21 / $291.83	Professional		$144.13	$215.21	$291.83
United Facility/Professional Professional Modifier Low / Median / High Price $92.64 / $119.82 / $294.50	Professional		$92.64	$119.82	$294.50