Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.07 / $365.35 / $517.30	Facility		$225.07	$365.35	$517.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $225.07 / $752.50	Professional		$204.61	$225.07	$752.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $313.56 / $1,026.20	Facility		$200.00	$313.56	$1,026.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $196.42 / $204.61 / $236.58	Professional		$196.42	$204.61	$236.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.03 / $193.03 / $498.48	Facility		$193.03	$193.03	$498.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $204.61 / $250.94	Professional		$204.61	$204.61	$250.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $184.71 / $205.28 / $225.80	Professional		$184.71	$205.28	$225.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $204.61 / $235.50 / $613.83	Facility		$204.61	$235.50	$613.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $195.36 / $314.58 / $559.91	Facility		$195.36	$314.58	$559.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.36 / $223.01 / $397.54	Professional		$195.36	$223.01	$397.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $204.61 / $246.67 / $457.68	Facility		$204.61	$246.67	$457.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $204.61 / $235.30	Professional		$204.61	$204.61	$235.30
United Facility/Professional Professional Modifier Low / Median / High Price $173.92 / $204.61 / $204.61	Professional		$173.92	$204.61	$204.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $204.61 / $204.61	Professional		$204.61	$204.61	$204.61