Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.23 / $221.65 / $430.40	Facility		$166.23	$221.65	$430.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.22 / $170.69 / $241.61	Professional		$129.22	$170.69	$241.61
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $231.00 / $231.00 / $231.00	Professional	25	$231.00	$231.00	$231.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $215.63 / $337.30 / $820.50	Facility		$215.63	$337.30	$820.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $218.01 / $344.82 / $491.65	Professional		$218.01	$344.82	$491.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.30 / $341.24 / $488.06	Professional		$147.30	$341.24	$488.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $314.20 / $314.20 / $314.20	Facility		$314.20	$314.20	$314.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $314.20 / $314.20 / $314.20	Professional		$314.20	$314.20	$314.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.69 / $292.63 / $469.91	Professional		$55.69	$292.63	$469.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $228.20 / $315.57 / $363.14	Facility		$228.20	$315.57	$363.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $215.63 / $215.63 / $234.96	Facility		$215.63	$215.63	$234.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $237.13 / $381.76 / $491.65	Professional		$237.13	$381.76	$491.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.01 / $356.21 / $479.94	Professional		$218.01	$356.21	$479.94
United Facility/Professional Professional Modifier Low / Median / High Price $178.00 / $226.08 / $511.09	Professional		$178.00	$226.08	$511.09