Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.88 / $399.58 / $966.45	Facility		$164.88	$399.58	$966.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.50 / $164.88 / $279.43	Professional		$110.50	$164.88	$279.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $184.17 / $280.64 / $724.65	Facility		$184.17	$280.64	$724.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $157.86 / $342.97 / $1,315.50	Professional		$157.86	$342.97	$1,315.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.42 / $372.85 / $452.90	Facility		$182.42	$372.85	$452.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.84 / $185.56 / $248.42	Professional		$83.84	$185.56	$248.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $175.40 / $219.25 / $600.92	Facility		$175.40	$219.25	$600.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $298.18 / $543.08	Professional		$175.40	$298.18	$543.08
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 $175.40 / $175.40 / $263.10	Facility		$175.40	$175.40	$263.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $175.40 / $306.95 / $526.20	Facility		$175.40	$306.95	$526.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.86 / $219.25 / $264.85	Professional		$157.86	$219.25	$264.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $184.17 / $280.64 / $482.35	Facility		$184.17	$280.64	$482.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $193.99 / $341.44 / $407.90	Professional		$193.99	$341.44	$407.90
United Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $175.40 / $175.40	Facility		$99.13	$175.40	$175.40
United Facility/Professional Professional Modifier Low / Median / High Price $73.67 / $73.67 / $196.45	Professional		$73.67	$73.67	$196.45