Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $198.94 / $471.49 / $619.75	Facility		$198.94	$471.49	$619.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.83 / $198.94 / $471.49	Professional		$176.83	$198.94	$471.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $258.12 / $607.39 / $1,539.25	Facility		$258.12	$607.39	$1,539.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $215.19 / $288.88 / $1,957.34	Professional		$215.19	$288.88	$1,957.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.69 / $190.69 / $190.69	Facility		$190.69	$190.69	$190.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $139.19 / $190.69	Professional		$139.19	$139.19	$190.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $185.64 / $313.75 / $807.78	Facility		$185.64	$313.75	$807.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $185.84 / $315.58 / $625.59	Professional		$185.84	$315.58	$625.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $203.38 / $225.98 / $248.57	Professional		$203.38	$225.98	$248.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $233.99 / $287.87 / $393.04	Facility		$233.99	$287.87	$393.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $234.18 / $294.77 / $393.04	Professional		$234.18	$294.77	$393.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.12 / $331.05 / $575.74	Facility		$258.12	$331.05	$575.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $280.58 / $287.87 / $287.87	Facility		$280.58	$287.87	$287.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $234.18 / $250.56 / $324.26	Professional		$234.18	$250.56	$324.26
United Facility/Professional Professional Modifier Low / Median / High Price $135.97 / $158.63 / $280.58	Professional		$135.97	$158.63	$280.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.92 / $48.92 / $176.99	Professional		$48.92	$48.92	$176.99