Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.09 / $323.27 / $2,596.85	Facility		$194.09	$323.27	$2,596.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $194.09 / $1,673.43	Professional		$176.45	$194.09	$1,673.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $180.54 / $272.89 / $1,272.84	Facility		$180.54	$272.89	$1,272.84
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $194.10 / $2,475.46	Professional		$176.45	$194.10	$2,475.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.46 / $176.45 / $438.42	Facility		$166.46	$176.45	$438.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $176.45 / $216.40	Professional		$176.45	$176.45	$216.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $176.45 / $262.81 / $564.40	Facility		$176.45	$262.81	$564.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $259.12 / $490.55	Professional		$176.45	$259.12	$490.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $189.51 / $211.74	Professional		$75.00	$189.51	$211.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $155.41 / $194.28 / $466.26	Facility		$155.41	$194.28	$466.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $163.16 / $300.95 / $507.65	Facility		$163.16	$300.95	$507.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.26 / $243.90 / $416.17	Professional		$201.26	$243.90	$416.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $180.54 / $215.62 / $401.97	Facility		$180.54	$215.62	$401.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $194.10 / $211.74	Professional		$176.45	$194.10	$211.74
United Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $176.45 / $220.56	Professional		$176.45	$176.45	$220.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $176.45 / $180.79	Professional		$176.45	$176.45	$180.79