Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $260.20 / $450.15 / $616.66	Facility		$260.20	$450.15	$616.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.96 / $260.20 / $304.89	Professional		$247.96	$260.20	$304.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $290.81 / $290.81 / $1,093.28	Facility		$290.81	$290.81	$1,093.28
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $261.73 / $290.81 / $1,311.93	Professional		$261.73	$290.81	$1,311.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $260.20 / $260.20 / $520.40	Facility		$260.20	$260.20	$520.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.20 / $260.20 / $260.20	Professional		$260.20	$260.20	$260.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $80.29 / $169.05 / $573.79	Facility		$80.29	$169.05	$573.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.29 / $171.78 / $578.00	Professional		$80.29	$171.78	$578.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $319.89	Professional		$75.00	$75.00	$319.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $290.81 / $290.81 / $456.27	Facility		$290.81	$290.81	$456.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $290.81 / $290.81 / $290.81	Facility		$290.81	$290.81	$290.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $290.81 / $290.81 / $290.81	Professional		$290.81	$290.81	$290.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $290.81 / $290.81 / $290.81	Facility		$290.81	$290.81	$290.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $276.27 / $290.81 / $290.81	Professional		$276.27	$290.81	$290.81
United Facility/Professional Professional Modifier Low / Median / High Price $255.10 / $255.10 / $306.12	Professional		$255.10	$255.10	$306.12