Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $462.48 / $462.48 / $462.48	Facility		$462.48	$462.48	$462.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.16 / $462.48 / $528.66	Professional		$254.16	$462.48	$528.66
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 $85.01 / $148.93 / $650.13	Professional		$85.01	$148.93	$650.13
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 $94.64 / $136.38 / $206.22	Professional		$94.64	$136.38	$206.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.70 / $172.02 / $1,678.39	Facility		$74.70	$172.02	$1,678.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.70 / $157.66 / $209.64	Professional		$74.70	$157.66	$209.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.43 / $45.00 / $50.00	Professional		$9.43	$45.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.12 / $117.43 / $120.60	Facility		$79.12	$117.43	$120.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $245.84 / $245.84 / $245.84	Professional		$245.84	$245.84	$245.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.26 / $82.26 / $83.35	Facility		$82.26	$82.26	$83.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.47 / $137.21 / $168.71	Professional		$92.47	$137.21	$168.71
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 $85.01 / $124.56 / $192.24	Professional		$85.01	$124.56	$192.24
United Facility/Professional Professional Modifier Low / Median / High Price $184.24 / $361.87 / $1,053.47	Professional		$184.24	$361.87	$1,053.47