Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.19 / $244.60 / $451.55	Facility		$223.19	$244.60	$451.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $219.26 / $262.68	Professional		$217.09	$219.26	$262.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $321.83 / $1,073.80	Facility		$208.93	$321.83	$1,073.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $238.80 / $948.17	Professional		$217.09	$238.80	$948.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.80 / $214.76 / $217.09	Facility		$204.80	$214.76	$217.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $217.09 / $266.24	Professional		$217.09	$217.09	$266.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $217.09 / $217.09 / $656.12	Facility		$217.09	$217.09	$656.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $217.09 / $387.00	Professional		$217.09	$217.09	$387.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $236.23 / $289.92	Professional		$75.00	$236.23	$289.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $214.56 / $217.09 / $378.84	Facility		$214.56	$217.09	$378.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $188.03 / $319.66 / $584.99	Facility		$188.03	$319.66	$584.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $226.91 / $273.51 / $494.34	Professional		$226.91	$273.51	$494.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $214.56 / $254.79 / $477.72	Facility		$214.56	$254.79	$477.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $238.80 / $260.51	Professional		$217.09	$238.80	$260.51
United Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $217.09 / $260.51	Professional		$217.09	$217.09	$260.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $214.76 / $217.09 / $217.09	Professional		$214.76	$217.09	$217.09