Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.36 / $563.85 / $78,927.60	Facility		$253.36	$563.85	$78,927.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $253.36 / $429.72	Professional		$238.46	$253.36	$429.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $239.95 / $359.93 / $1,201.00	Facility		$239.95	$359.93	$1,201.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $254.85 / $283.17 / $1,284.26	Professional		$254.85	$283.17	$1,284.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $241.21 / $241.21 / $496.78	Facility		$241.21	$241.21	$496.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.36 / $253.36 / $253.36	Professional		$253.36	$253.36	$253.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $612.88 / $43,775.00 / $43,775.00	Facility		$612.88	$43,775.00	$43,775.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $283.17 / $488.02 / $488.02	Professional		$283.17	$488.02	$488.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $75.00	Professional		$30.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $271.12 / $271.12 / $79,999.20	Facility		$271.12	$271.12	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $206.78 / $360.40 / $643.30	Facility		$206.78	$360.40	$643.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.12 / $271.12 / $271.12	Professional		$271.12	$271.12	$271.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $239.95 / $287.94 / $534.25	Facility		$239.95	$287.94	$534.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $269.01 / $283.17 / $294.50	Professional		$269.01	$283.17	$294.50
United Facility/Professional Professional Modifier Low / Median / High Price $248.39 / $248.39 / $298.07	Professional		$248.39	$248.39	$298.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $237.83 / $283.17 / $283.17	Professional		$237.83	$283.17	$283.17