Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.78 / $312.10 / $754.87	Facility		$128.78	$312.10	$754.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $202.01 / $333.94	Professional		$45.00	$202.01	$333.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $143.85 / $219.20 / $566.00	Facility		$143.85	$219.20	$566.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $123.30 / $284.95 / $1,027.50	Professional		$123.30	$284.95	$1,027.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.08 / $248.95 / $356.20	Facility		$23.08	$248.95	$356.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.34 / $153.47 / $193.84	Professional		$72.34	$153.47	$193.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $135.47 / $171.25 / $391.85	Facility		$135.47	$171.25	$391.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $201.39 / $379.00	Professional		$137.00	$201.39	$379.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $134.12 / $145.37	Professional		$75.00	$134.12	$145.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $137.00 / $137.00 / $287.70	Facility		$137.00	$137.00	$287.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $137.00 / $239.75 / $411.00	Facility		$137.00	$239.75	$411.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.30 / $171.25 / $206.87	Professional		$123.30	$171.25	$206.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $143.85 / $224.82 / $376.75	Facility		$143.85	$224.82	$376.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $151.52 / $266.68 / $318.89	Professional		$151.52	$266.68	$318.89
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $153.44	Professional		$57.54	$57.54	$153.44