Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.07 / $294.80 / $498.94	Facility		$156.07	$294.80	$498.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.89 / $156.07 / $312.14	Professional		$102.89	$156.07	$312.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $473.69 / $689.38 / $1,348.64	Facility		$473.69	$689.38	$1,348.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $182.95 / $305.91 / $1,174.00	Professional		$182.95	$305.91	$1,174.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.76 / $532.62 / $1,161.91	Facility		$118.76	$532.62	$1,161.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.13 / $276.88 / $419.46	Professional		$165.13	$276.88	$419.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $142.29 / $269.00 / $679.49	Facility		$142.29	$269.00	$679.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $142.29 / $292.33 / $420.53	Professional		$142.29	$292.33	$420.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.20 / $128.75 / $291.61	Professional		$24.20	$128.75	$291.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $214.50 / $259.68 / $321.02	Facility		$214.50	$259.68	$321.02
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $172.71 / $172.71 / $172.71	Professional		$172.71	$172.71	$172.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $178.23 / $178.23 / $179.39	Facility		$178.23	$178.23	$179.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.08 / $298.27 / $356.99	Professional		$202.08	$298.27	$356.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $484.26 / $695.39 / $1,340.75	Facility		$484.26	$695.39	$1,340.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $182.95 / $269.88 / $354.10	Professional		$182.95	$269.88	$354.10
United Facility/Professional Professional Modifier Low / Median / High Price $118.41 / $152.99 / $357.39	Professional		$118.41	$152.99	$357.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $142.71 / $142.71 / $142.71	Professional		$142.71	$142.71	$142.71