Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.77 / $297.52 / $789.27	Facility		$172.77	$297.52	$789.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.45 / $88.62 / $250.40	Professional		$45.45	$88.62	$250.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $151.06 / $283.23	Facility		$99.13	$151.06	$283.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $94.41 / $203.63 / $819.00	Professional		$94.41	$203.63	$819.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.63 / $221.58 / $526.32	Facility		$192.63	$221.58	$526.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.70 / $82.70 / $136.88	Professional		$82.70	$82.70	$136.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $93.00 / $165.00 / $292.30	Facility		$93.00	$165.00	$292.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $160.50 / $283.23	Professional		$93.00	$160.50	$283.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $92.42 / $92.42 / $100.18	Professional		$92.42	$92.42	$100.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $94.41 / $94.41 / $240.00	Facility		$94.41	$94.41	$240.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.41 / $164.27 / $283.23	Facility		$94.41	$164.27	$283.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.97 / $84.97 / $84.97	Professional		$84.97	$84.97	$84.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $151.06 / $259.63	Facility		$99.13	$151.06	$259.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $122.73 / $186.70 / $257.08	Professional		$122.73	$186.70	$257.08
United Facility/Professional Professional Modifier Low / Median / High Price $39.53 / $39.65 / $105.74	Professional		$39.53	$39.65	$105.74