Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $255.21 / $457.55 / $579.33	Facility		$255.21	$457.55	$579.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.86 / $255.21 / $604.85	Professional		$169.86	$255.21	$604.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $331.15 / $819.39 / $1,587.88	Facility		$331.15	$819.39	$1,587.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $232.98 / $321.45 / $2,590.42	Professional		$232.98	$321.45	$2,590.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $196.21 / $196.21 / $196.21	Facility		$196.21	$196.21	$196.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.22 / $143.22 / $196.21	Professional		$143.22	$143.22	$196.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $190.64 / $363.92 / $868.12	Facility		$190.64	$363.92	$868.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.85 / $359.27 / $643.79	Professional		$190.85	$359.27	$643.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $260.92 / $289.92 / $318.91	Professional		$260.92	$289.92	$318.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $296.22 / $333.66 / $378.18	Facility		$296.22	$333.66	$378.18
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $303.33 / $378.18 / $378.18	Professional		$303.33	$378.18	$378.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.15 / $424.72 / $738.64	Facility		$331.15	$424.72	$738.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $359.96 / $369.32 / $369.32	Facility		$359.96	$369.32	$369.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $300.44 / $321.45 / $416.00	Professional		$300.44	$321.45	$416.00
United Facility/Professional Professional Modifier Low / Median / High Price $142.44 / $163.22 / $288.70	Professional		$142.44	$163.22	$288.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $78.06 / $181.32	Professional		$78.06	$78.06	$181.32