Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.91 / $644.42 / $1,558.67	Facility		$265.91	$644.42	$1,558.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.72 / $265.91 / $517.62	Professional		$169.72	$265.91	$517.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $297.02 / $452.61 / $1,168.69	Facility		$297.02	$452.61	$1,168.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $265.91 / $552.85 / $2,121.60	Professional		$265.91	$552.85	$2,121.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $284.89 / $579.19 / $730.42	Facility		$284.89	$579.19	$730.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.13 / $299.11 / $400.43	Professional		$135.13	$299.11	$400.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $282.88 / $353.60 / $968.43	Facility		$282.88	$353.60	$968.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $480.90 / $875.20	Professional		$282.88	$480.90	$875.20
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 $282.88 / $282.88 / $424.32	Facility		$282.88	$282.88	$424.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $282.88 / $495.04 / $848.64	Facility		$282.88	$495.04	$848.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $254.59 / $353.60 / $427.15	Professional		$254.59	$353.60	$427.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $297.02 / $452.61 / $777.92	Facility		$297.02	$452.61	$777.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $312.87 / $550.21 / $657.90	Professional		$312.87	$550.21	$657.90
United Facility/Professional Professional Modifier Low / Median / High Price $118.81 / $118.81 / $316.83	Professional		$118.81	$118.81	$316.83