Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.63 / $384.43 / $929.81	Facility		$158.63	$384.43	$929.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.46 / $158.63 / $249.75	Professional		$58.46	$158.63	$249.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $168.75 / $270.00 / $697.17	Facility		$168.75	$270.00	$697.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $143.44 / $329.73 / $1,265.63	Professional		$143.44	$329.73	$1,265.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.36 / $272.02 / $435.74	Facility		$37.36	$272.02	$435.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.14 / $189.09 / $230.06	Professional		$89.14	$189.09	$230.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $166.47 / $210.94 / $481.52	Facility		$166.47	$210.94	$481.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $168.75 / $248.06 / $466.92	Professional		$168.75	$248.06	$466.92
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 $168.75 / $168.75 / $354.38	Facility		$168.75	$168.75	$354.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.88 / $295.31 / $506.25	Facility		$151.88	$295.31	$506.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.88 / $210.94 / $254.81	Professional		$151.88	$210.94	$254.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $177.19 / $276.92 / $464.06	Facility		$177.19	$276.92	$464.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.64 / $328.64 / $392.42	Professional		$186.64	$328.64	$392.42
United Facility/Professional Professional Modifier Low / Median / High Price $70.88 / $70.88 / $202.50	Professional		$70.88	$70.88	$202.50