Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $222.39 / $504.83 / $527.05	Facility		$222.39	$504.83	$527.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.70 / $222.39 / $222.39	Professional		$125.70	$222.39	$222.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $282.97 / $1,166.45 / $1,166.45	Facility		$282.97	$1,166.45	$1,166.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $85.54 / $252.70 / $1,918.35	Professional		$85.54	$252.70	$1,918.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $210.68 / $210.68 / $210.68	Facility		$210.68	$210.68	$210.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.80 / $153.80 / $210.68	Professional		$153.80	$153.80	$210.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $206.46 / $464.53 / $750.27	Facility		$206.46	$464.53	$750.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $206.46 / $438.09 / $602.61	Professional		$206.46	$438.09	$602.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $242.66 / $400.91 / $441.53	Facility		$242.66	$400.91	$441.53
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $242.66 / $242.66 / $242.66	Professional		$242.66	$242.66	$242.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $274.20 / $329.04 / $601.16	Facility		$274.20	$329.04	$601.16
United Facility/Professional Professional Modifier Low / Median / High Price $141.57 / $157.02 / $237.83	Professional		$141.57	$157.02	$237.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $156.18 / $156.18 / $183.74	Professional		$156.18	$156.18	$183.74