Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $226.40 / $743.48 / $1,576.34	Facility		$226.40	$743.48	$1,576.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.78 / $200.09 / $363.39	Professional		$138.78	$200.09	$363.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $272.55 / $616.16 / $1,417.95	Facility		$272.55	$616.16	$1,417.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $210.46 / $272.55 / $1,852.79	Professional		$210.46	$272.55	$1,852.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $175.81 / $175.81 / $191.33	Facility		$175.81	$175.81	$191.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.34 / $128.34 / $191.33	Professional		$128.34	$128.34	$191.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $167.89 / $311.26 / $763.12	Facility		$167.89	$311.26	$763.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $168.07 / $307.04 / $565.17	Professional		$168.07	$307.04	$565.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $214.74 / $238.61 / $262.47	Professional		$214.74	$238.61	$262.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $247.08 / $290.88 / $311.26	Facility		$247.08	$290.88	$311.26
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $280.13 / $311.26 / $311.26	Professional		$280.13	$311.26	$311.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $272.55 / $349.55 / $607.91	Facility		$272.55	$349.55	$607.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $296.26 / $303.95 / $303.95	Facility		$296.26	$303.95	$303.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $247.26 / $264.57 / $342.39	Professional		$247.26	$264.57	$342.39
United Facility/Professional Professional Modifier Low / Median / High Price $122.93 / $132.96 / $253.66	Professional		$122.93	$132.96	$253.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $84.83 / $84.83 / $125.00	Professional		$84.83	$84.83	$125.00