Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.78 / $219.48 / $520.16	Facility		$87.78	$219.48	$520.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.07 / $204.45 / $379.70	Professional		$166.07	$204.45	$379.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $284.77 / $684.80 / $1,611.98	Facility		$284.77	$684.80	$1,611.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $229.19 / $284.77 / $2,164.82	Professional		$229.19	$284.77	$2,164.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $216.42 / $216.42 / $244.45	Facility		$216.42	$216.42	$244.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.99 / $157.99 / $244.45	Professional		$157.99	$157.99	$244.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $204.36 / $331.73 / $885.93	Facility		$204.36	$331.73	$885.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.44 / $342.27 / $657.03	Professional		$205.44	$342.27	$657.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $224.38 / $249.32 / $274.25	Professional		$224.38	$249.32	$274.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $258.14 / $317.61 / $361.98	Facility		$258.14	$317.61	$361.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $276.45 / $325.23 / $361.98	Professional		$276.45	$325.23	$361.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $284.77 / $365.25 / $635.22	Facility		$284.77	$365.25	$635.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $309.56 / $317.61 / $317.61	Facility		$309.56	$317.61	$317.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $258.36 / $276.45 / $357.75	Professional		$258.36	$276.45	$357.75
United Facility/Professional Facility Modifier Low / Median / High Price $118.96 / $153.02 / $166.54	Facility		$118.96	$153.02	$166.54
United Facility/Professional Professional Modifier Low / Median / High Price $142.75 / $154.40 / $294.57	Professional		$142.75	$154.40	$294.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.20 / $56.20 / $186.65	Professional		$56.20	$56.20	$186.65