Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.00 / $465.35 / $485.85	Facility		$205.00	$465.35	$485.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.22 / $205.00 / $485.85	Professional		$182.22	$205.00	$485.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $160.29 / $519.74 / $1,660.98	Facility		$160.29	$519.74	$1,660.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $140.33 / $259.87 / $1,270.80	Professional		$140.33	$259.87	$1,270.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $382.03 / $382.03 / $382.03	Facility		$382.03	$382.03	$382.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.88 / $278.88 / $382.03	Professional		$278.88	$278.88	$382.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $156.84 / $620.15 / $1,822.55	Facility		$156.84	$620.15	$1,822.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.84 / $614.67 / $1,029.30	Professional		$156.84	$614.67	$1,029.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $440.17 / $489.08 / $537.98	Professional		$440.17	$489.08	$537.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.09 / $246.04 / $506.39	Facility		$165.09	$246.04	$506.39
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $506.82 / $506.82 / $506.82	Professional		$506.82	$506.82	$506.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.25 / $259.87 / $320.58	Facility		$136.25	$259.87	$320.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.25 / $254.86 / $503.24	Professional		$136.25	$254.86	$503.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $160.29 / $160.29 / $272.02	Facility		$160.29	$160.29	$272.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $133.31 / $141.97 / $506.82	Professional		$133.31	$141.97	$506.82
United Facility/Professional Professional Modifier Low / Median / High Price $246.14 / $257.63 / $429.38	Professional		$246.14	$257.63	$429.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $327.38 / $327.38 / $327.38	Professional		$327.38	$327.38	$327.38