Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $227.58 / $516.61 / $1,333.00	Facility		$227.58	$516.61	$1,333.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.99 / $227.58 / $539.37	Professional		$195.99	$227.58	$539.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $295.29 / $701.37 / $1,609.26	Facility		$295.29	$701.37	$1,609.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $192.18 / $293.39 / $1,742.90	Professional		$192.18	$293.39	$1,742.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.91 / $192.91 / $192.91	Facility		$192.91	$192.91	$192.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.82 / $140.82 / $192.91	Professional		$140.82	$140.82	$192.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $216.69 / $370.81 / $884.06	Facility		$216.69	$370.81	$884.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $216.69 / $357.23 / $655.38	Professional		$216.69	$357.23	$655.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $232.65 / $258.51 / $284.36	Professional		$232.65	$258.51	$284.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $267.69 / $329.33 / $349.98	Facility		$267.69	$329.33	$349.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $303.51 / $337.23 / $349.98	Professional		$303.51	$337.23	$349.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.29 / $378.73 / $658.66	Facility		$295.29	$378.73	$658.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $320.98 / $329.33 / $329.33	Facility		$320.98	$329.33	$329.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $267.89 / $286.64 / $370.95	Professional		$267.89	$286.64	$370.95
United Facility/Professional Professional Modifier Low / Median / High Price $142.40 / $154.02 / $293.85	Professional		$142.40	$154.02	$293.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $186.58 / $186.58 / $186.58	Professional		$186.58	$186.58	$186.58