Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.94 / $190.33 / $8,251.87	Facility		$163.94	$190.33	$8,251.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $174.76 / $227.76	Professional		$173.03	$174.76	$227.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $150.66 / $238.04 / $824.60	Facility		$150.66	$238.04	$824.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $190.33 / $2,975.90	Professional		$173.03	$190.33	$2,975.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.24 / $165.71 / $401.85	Facility		$163.24	$165.71	$401.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $173.03 / $212.21	Professional		$173.03	$173.03	$212.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.76 / $173.03 / $387.51	Facility		$125.76	$173.03	$387.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.21 / $173.03 / $331.15	Professional		$119.21	$173.03	$331.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $181.41 / $222.64	Professional		$75.00	$181.41	$222.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $172.55 / $195.88 / $359.90	Facility		$172.55	$195.88	$359.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $130.41 / $230.51 / $421.85	Facility		$130.41	$230.51	$421.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.09 / $211.05 / $381.45	Professional		$175.09	$211.05	$381.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $158.69 / $190.33 / $317.38	Facility		$158.69	$190.33	$317.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $190.33 / $207.64	Professional		$173.03	$190.33	$207.64
United Facility/Professional Facility Modifier Low / Median / High Price $164.92 / $164.92 / $164.92	Facility		$164.92	$164.92	$164.92
United Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $173.03 / $207.64	Professional		$173.03	$173.03	$207.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.71 / $173.03 / $173.03	Professional		$165.71	$173.03	$173.03