Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.62 / $350.00 / $622.20	Facility		$142.62	$350.00	$622.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.17 / $142.63 / $196.00	Professional		$74.17	$142.63	$196.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $216.00 / $677.49	Facility		$142.63	$216.00	$677.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $128.37 / $278.74 / $1,069.73	Professional		$128.37	$278.74	$1,069.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.99 / $231.78 / $368.29	Facility		$96.99	$231.78	$368.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.25 / $160.08 / $218.86	Professional		$79.25	$160.08	$218.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $178.29 / $487.50	Facility		$142.63	$178.29	$487.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $178.29 / $440.55	Professional		$142.63	$178.29	$440.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $139.63 / $151.36	Professional		$75.00	$139.63	$151.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $149.76 / $213.95	Facility		$142.63	$149.76	$213.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.37 / $128.37 / $142.63	Facility		$128.37	$128.37	$142.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.37 / $178.29 / $215.37	Professional		$128.37	$178.29	$215.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $149.76 / $228.34 / $392.23	Facility		$149.76	$228.34	$392.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $157.75 / $268.75 / $331.27	Professional		$157.75	$268.75	$331.27
United Facility/Professional Professional Modifier Low / Median / High Price $59.90 / $66.69 / $171.16	Professional		$59.90	$66.69	$171.16