Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.94 / $703.56 / $734.56	Facility		$309.94	$703.56	$734.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.01 / $309.94 / $734.56	Professional		$212.01	$309.94	$734.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $402.15 / $1,222.18 / $2,077.64	Facility		$402.15	$1,222.18	$2,077.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $292.01 / $390.38 / $3,863.70	Professional		$292.01	$390.38	$3,863.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $236.57 / $236.57 / $236.57	Facility		$236.57	$236.57	$236.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.70 / $172.70 / $236.57	Professional		$172.70	$172.70	$236.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $238.42 / $454.10 / $1,083.75	Facility		$238.42	$454.10	$1,083.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $238.68 / $440.04 / $803.50	Professional		$238.68	$440.04	$803.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $316.87 / $352.08 / $387.28	Professional		$316.87	$352.08	$387.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $364.56 / $413.34 / $459.27	Facility		$364.56	$413.34	$459.27
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $378.59 / $459.27 / $473.24	Professional		$378.59	$459.27	$473.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $402.15 / $515.79 / $897.02	Facility		$402.15	$515.79	$897.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $437.14 / $448.51 / $448.51	Facility		$437.14	$448.51	$448.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $364.85 / $390.38 / $505.20	Professional		$364.85	$390.38	$505.20
United Facility/Professional Professional Modifier Low / Median / High Price $174.63 / $189.18 / $360.35	Professional		$174.63	$189.18	$360.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $130.10 / $130.10 / $221.70	Professional		$130.10	$130.10	$221.70