Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.29 / $349.92 / $1,121.29	Facility		$191.29	$349.92	$1,121.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.78 / $191.29 / $334.32	Professional		$154.78	$191.29	$334.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $213.68 / $325.60 / $712.25	Facility		$213.68	$325.60	$712.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $183.15 / $397.92 / $1,526.25	Professional		$183.15	$397.92	$1,526.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.95 / $432.60 / $583.37	Facility		$204.95	$432.60	$583.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.49 / $214.98 / $277.41	Professional		$107.49	$214.98	$277.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $200.57 / $256.95 / $630.35	Facility		$200.57	$256.95	$630.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $203.50 / $299.14 / $563.95	Professional		$203.50	$299.14	$563.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $199.23 / $215.95	Professional		$75.00	$199.23	$215.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $203.50 / $203.50 / $427.35	Facility		$203.50	$203.50	$427.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.50 / $356.13 / $610.50	Facility		$203.50	$356.13	$610.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.15 / $254.38 / $307.29	Professional		$183.15	$254.38	$307.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.68 / $333.94 / $559.63	Facility		$213.68	$333.94	$559.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $225.07 / $395.99 / $472.91	Professional		$225.07	$395.99	$472.91
United Facility/Professional Facility Modifier Low / Median / High Price $122.58 / $203.50 / $203.50	Facility		$122.58	$203.50	$203.50
United Facility/Professional Professional Modifier Low / Median / High Price $85.47 / $92.96 / $227.92	Professional		$85.47	$92.96	$227.92