Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.32 / $398.24 / $963.20	Facility		$164.32	$398.24	$963.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.03 / $131.91 / $169.77	Professional		$59.03	$131.91	$169.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $183.55 / $279.70 / $722.21	Facility		$183.55	$279.70	$722.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $157.33 / $341.64 / $1,311.08	Professional		$157.33	$341.64	$1,311.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.47 / $281.80 / $454.52	Facility		$87.47	$281.80	$454.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.67 / $184.87 / $238.55	Professional		$83.67	$184.87	$238.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $167.03 / $235.68 / $541.38	Facility		$167.03	$235.68	$541.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $172.67 / $256.97 / $474.84	Professional		$172.67	$256.97	$474.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $171.13 / $185.50	Professional		$75.00	$171.13	$185.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $174.81 / $262.22	Facility		$174.81	$174.81	$262.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $305.92 / $524.42	Facility		$174.81	$305.92	$524.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.33 / $218.51 / $263.95	Professional		$157.33	$218.51	$263.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $183.55 / $279.70 / $480.73	Facility		$183.55	$279.70	$480.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $193.34 / $340.09 / $406.35	Professional		$193.34	$340.09	$406.35
United Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $73.42 / $195.79	Professional		$73.42	$73.42	$195.79