Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.00 / $554.45 / $1,418.55	Facility		$242.00	$554.45	$1,418.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.19 / $242.00 / $529.73	Professional		$162.19	$242.00	$529.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $270.32 / $422.48 / $1,063.63	Facility		$270.32	$422.48	$1,063.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $231.71 / $534.91 / $1,930.88	Professional		$231.71	$534.91	$1,930.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $267.74 / $547.25 / $826.40	Facility		$267.74	$547.25	$826.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.69 / $288.58 / $394.55	Professional		$160.69	$288.58	$394.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $257.45 / $378.45 / $796.40	Facility		$257.45	$378.45	$796.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.45 / $454.71 / $796.40	Professional		$257.45	$454.71	$796.40
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 $257.45 / $257.45 / $540.65	Facility		$257.45	$257.45	$540.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.45 / $450.54 / $772.35	Facility		$257.45	$450.54	$772.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.71 / $321.81 / $388.75	Professional		$231.71	$321.81	$388.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $270.32 / $424.79 / $707.99	Facility		$270.32	$424.79	$707.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $300.18 / $501.05 / $598.29	Professional		$300.18	$501.05	$598.29
United Facility/Professional Professional Modifier Low / Median / High Price $108.13 / $147.29 / $288.33	Professional		$108.13	$147.29	$288.33