Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.09 / $316.51 / $359.64	Facility		$216.09	$316.51	$359.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.16 / $216.09 / $348.53	Professional		$134.16	$216.09	$348.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $501.48 / $1,129.34 / $2,161.55	Facility		$501.48	$1,129.34	$2,161.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $207.90 / $360.97 / $1,339.80	Professional		$207.90	$360.97	$1,339.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.19 / $244.27 / $473.88	Professional		$151.19	$244.27	$473.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $162.12 / $263.68 / $416.90	Facility		$162.12	$263.68	$416.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.12 / $263.68 / $416.90	Professional		$162.12	$263.68	$416.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $201.25 / $362.26	Professional		$36.60	$201.25	$362.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $178.36 / $256.50 / $307.52	Facility		$178.36	$256.50	$307.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.85 / $203.85 / $209.76	Facility		$203.85	$203.85	$209.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.76 / $346.97 / $416.36	Professional		$209.76	$346.97	$416.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $732.75 / $1,129.34 / $2,161.55	Facility		$732.75	$1,129.34	$2,161.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.35 / $282.06 / $391.12	Professional		$204.35	$282.06	$391.12
United Facility/Professional Professional Modifier Low / Median / High Price $155.00 / $200.73 / $433.21	Professional		$155.00	$200.73	$433.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $178.02 / $178.02 / $178.02	Professional		$178.02	$178.02	$178.02