Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $244.87 / $415.00 / $1,435.36	Facility		$244.87	$415.00	$1,435.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.25 / $244.87 / $260.50	Professional		$130.25	$244.87	$260.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $273.52 / $488.03 / $1,237.38	Facility		$273.52	$488.03	$1,237.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $117.25 / $281.33 / $1,302.50	Professional		$117.25	$281.33	$1,302.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.25 / $270.93 / $672.66	Facility		$185.25	$270.93	$672.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $299.43 / $374.28	Professional		$161.63	$299.43	$374.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $257.30 / $329.40 / $805.72	Facility		$257.30	$329.40	$805.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $260.50 / $382.94 / $720.85	Professional		$260.50	$382.94	$720.85
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 $260.50 / $260.50 / $547.04	Facility		$260.50	$260.50	$547.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $260.50 / $390.75 / $716.38	Facility		$260.50	$390.75	$716.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.45 / $312.60 / $369.91	Professional		$234.45	$312.60	$369.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $273.52 / $427.48 / $716.38	Facility		$273.52	$427.48	$716.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $235.73 / $458.45 / $638.27	Professional		$235.73	$458.45	$638.27
United Facility/Professional Professional Modifier Low / Median / High Price $109.41 / $109.41 / $312.60	Professional		$109.41	$109.41	$312.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.23 / $117.23 / $134.94	Professional		$117.23	$117.23	$134.94