Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $319.88 / $319.88 / $319.88	Facility		$319.88	$319.88	$319.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.14 / $240.00 / $319.88	Professional		$180.14	$240.00	$319.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $338.13 / $496.63 / $991.21	Facility		$338.13	$496.63	$991.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $165.27 / $389.69 / $1,656.38	Professional		$165.27	$389.69	$1,656.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.32 / $205.32 / $205.32	Facility		$205.32	$205.32	$205.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.27 / $146.27 / $146.27	Professional		$146.27	$146.27	$146.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $183.83 / $322.81 / $551.53	Facility		$183.83	$322.81	$551.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.24 / $304.29 / $507.85	Professional		$184.24	$304.29	$507.85
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 $129.26 / $153.85 / $171.61	Facility		$129.26	$153.85	$171.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $400.00 / $400.00	Facility		$400.00	$400.00	$400.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $433.75 / $618.15	Professional		$400.00	$433.75	$618.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $338.13 / $451.10 / $846.77	Facility		$338.13	$451.10	$846.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $262.88 / $346.05 / $499.23	Professional		$262.88	$346.05	$499.23
United Facility/Professional Facility Modifier Low / Median / High Price $42.47 / $129.13 / $171.61	Facility		$42.47	$129.13	$171.61
United Facility/Professional Professional Modifier Low / Median / High Price $209.24 / $344.90 / $555.60	Professional		$209.24	$344.90	$555.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $171.61 / $242.80 / $242.80	Professional		$171.61	$242.80	$242.80