Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.89 / $194.71 / $673.43	Facility		$114.89	$194.71	$673.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.78 / $114.89 / $180.89	Professional		$64.78	$114.89	$180.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $128.33 / $200.56 / $504.94	Facility		$128.33	$200.56	$504.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $120.49 / $250.24 / $916.65	Professional		$120.49	$250.24	$916.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.32 / $221.66 / $357.48	Facility		$83.32	$221.66	$357.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.13 / $136.94 / $166.63	Professional		$72.13	$136.94	$166.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $190.80 / $400.51	Facility		$122.22	$190.80	$400.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $216.00 / $378.70	Professional		$122.22	$216.00	$378.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $122.22 / $183.33	Facility		$122.22	$122.22	$183.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $213.89 / $366.66	Facility		$122.22	$213.89	$366.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $152.78 / $184.55	Professional		$110.00	$152.78	$184.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.33 / $201.66 / $336.11	Facility		$128.33	$201.66	$336.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $135.18 / $237.73 / $284.06	Professional		$135.18	$237.73	$284.06
United Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $63.37 / $136.88	Professional		$51.33	$63.37	$136.88