Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.30 / $437.57 / $5,447.49	Facility		$262.30	$437.57	$5,447.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $240.84 / $471.16	Professional		$238.46	$240.84	$471.16
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $271.47 / $567.27 / $10,081.35	Facility		$271.47	$567.27	$10,081.35
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $262.31 / $16,586.83	Professional		$238.46	$262.31	$16,586.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.96 / $238.46 / $619.15	Facility		$224.96	$238.46	$619.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $238.46 / $292.45	Professional		$238.46	$238.46	$292.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $238.46 / $468.03 / $8,249.04	Facility		$238.46	$468.03	$8,249.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $454.95 / $7,998.73	Professional		$238.46	$454.95	$7,998.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $191.00 / $262.30	Professional		$75.00	$191.00	$262.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.64 / $247.45 / $655.52	Facility		$173.64	$247.45	$655.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $244.32 / $475.06 / $950.13	Facility		$244.32	$475.06	$950.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.23 / $344.44 / $587.72	Professional		$284.23	$344.44	$587.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $262.31 / $453.82 / $1,210.18	Facility		$262.31	$453.82	$1,210.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $262.31 / $286.14	Professional		$238.46	$262.31	$286.14
United Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $238.46 / $286.14	Professional		$238.46	$238.46	$286.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $238.46 / $255.32	Professional		$238.46	$238.46	$255.32