Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $215.52 / $236.18 / $428.75	Facility		$215.52	$236.18	$428.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $209.20 / $249.42	Professional		$207.13	$209.20	$249.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $200.01 / $304.14 / $1,025.20	Facility		$200.01	$304.14	$1,025.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $227.84 / $904.64	Professional		$207.13	$227.84	$904.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.40 / $204.90 / $410.08	Facility		$195.40	$204.90	$410.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $254.02	Professional		$207.13	$207.13	$254.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $207.13 / $621.28	Facility		$207.13	$207.13	$621.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $474.29	Professional		$207.13	$207.13	$474.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $225.54 / $276.80	Professional		$75.00	$225.54	$276.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $206.12 / $234.48 / $430.83	Facility		$206.12	$234.48	$430.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.01 / $306.01 / $560.03	Facility		$180.01	$306.01	$560.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.50 / $260.95 / $471.65	Professional		$216.50	$260.95	$471.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $202.76 / $243.31 / $425.29	Facility		$202.76	$243.31	$425.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $227.84 / $248.55	Professional		$207.13	$227.84	$248.55
United Facility/Professional Facility Modifier Low / Median / High Price $207.00 / $207.00 / $207.00	Facility		$207.00	$207.00	$207.00
United Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $248.56	Professional		$207.13	$207.13	$248.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.90 / $207.13 / $207.13	Professional		$204.90	$207.13	$207.13