Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.82 / $123.82 / $123.82	Facility		$123.82	$123.82	$123.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.12 / $123.82 / $148.37	Professional		$86.12	$123.82	$148.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $484.26 / $688.94 / $1,348.64	Facility		$484.26	$688.94	$1,348.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $145.53 / $248.30 / $1,194.00	Professional		$145.53	$248.30	$1,194.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $284.99 / $532.62 / $1,161.91	Facility		$284.99	$532.62	$1,161.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.97 / $229.38 / $334.54	Professional		$157.97	$229.38	$334.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $128.03 / $258.42 / $679.49	Facility		$128.03	$258.42	$679.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.03 / $250.62 / $348.90	Professional		$128.03	$250.62	$348.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.75 / $112.44 / $134.94	Professional		$19.75	$112.44	$134.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $137.28 / $206.44 / $209.04	Facility		$137.28	$206.44	$209.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $160.57 / $160.57 / $160.57	Professional		$160.57	$160.57	$160.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.58 / $142.58 / $142.69	Facility		$142.58	$142.58	$142.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.35 / $238.16 / $285.05	Professional		$161.35	$238.16	$285.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $484.26 / $688.94 / $1,340.75	Facility		$484.26	$688.94	$1,340.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $145.53 / $215.90 / $292.77	Professional		$145.53	$215.90	$292.77
United Facility/Professional Professional Modifier Low / Median / High Price $96.63 / $193.26 / $297.36	Professional		$96.63	$193.26	$297.36