Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.06 / $217.62 / $411.11	Facility		$201.06	$217.62	$411.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $199.81 / $239.16	Professional		$197.83	$199.81	$239.16
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $187.15 / $285.75 / $970.40	Facility		$187.15	$285.75	$970.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $217.61 / $855.93	Professional		$197.83	$217.61	$855.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.63 / $193.86 / $197.83	Facility		$186.63	$193.86	$197.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $242.62	Professional		$197.83	$197.83	$242.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $197.83 / $197.83 / $595.01	Facility		$197.83	$197.83	$595.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $465.12	Professional		$197.83	$197.83	$465.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $213.48 / $262.00	Professional		$75.00	$213.48	$262.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $190.50 / $197.83 / $335.97	Facility		$190.50	$197.83	$335.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.44 / $288.61 / $524.03	Facility		$168.44	$288.61	$524.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.84 / $246.90 / $446.25	Professional		$204.84	$246.90	$446.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $190.50 / $228.60 / $424.15	Facility		$190.50	$228.60	$424.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $217.61 / $237.40	Professional		$197.83	$217.61	$237.40
United Facility/Professional Facility Modifier Low / Median / High Price $320.23 / $320.23 / $320.23	Facility		$320.23	$320.23	$320.23
United Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $237.40	Professional		$197.83	$197.83	$237.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $193.86 / $197.83 / $197.83	Professional		$193.86	$197.83	$197.83