Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.26 / $461.09 / $1,115.22	Facility		$190.26	$461.09	$1,115.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.43 / $190.26 / $299.55	Professional		$121.43	$190.26	$299.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $212.52 / $323.83 / $836.20	Facility		$212.52	$323.83	$836.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $182.16 / $413.67 / $1,518.00	Professional		$182.16	$413.67	$1,518.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.28 / $326.27 / $526.24	Facility		$95.28	$326.27	$526.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.75 / $213.95 / $276.07	Professional		$96.75	$213.95	$276.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $193.23 / $272.64 / $626.10	Facility		$193.23	$272.64	$626.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.64 / $297.52 / $549.15	Professional		$199.64	$297.52	$549.15
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 $202.40 / $202.40 / $303.60	Facility		$202.40	$202.40	$303.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $202.40 / $354.20 / $607.20	Facility		$202.40	$354.20	$607.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.16 / $253.00 / $305.62	Professional		$182.16	$253.00	$305.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $212.52 / $323.83 / $556.60	Facility		$212.52	$323.83	$556.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $223.85 / $393.97 / $470.59	Professional		$223.85	$393.97	$470.59
United Facility/Professional Professional Modifier Low / Median / High Price $85.01 / $85.01 / $226.69	Professional		$85.01	$85.01	$226.69