Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $243.66 / $553.11 / $577.47	Facility		$243.66	$553.11	$577.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.78 / $243.66 / $577.47	Professional		$168.78	$243.66	$577.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $328.32 / $714.01 / $1,747.51	Facility		$328.32	$714.01	$1,747.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $257.45 / $326.20 / $1,856.00	Professional		$257.45	$326.20	$1,856.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $271.68 / $271.68 / $271.68	Facility		$271.68	$271.68	$271.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.33 / $198.33 / $271.68	Professional		$198.33	$198.33	$271.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $212.48 / $374.95 / $966.56	Facility		$212.48	$374.95	$966.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $212.71 / $374.95 / $715.78	Professional		$212.71	$374.95	$715.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $258.68 / $287.43 / $316.17	Professional		$258.68	$287.43	$316.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $297.61 / $337.55 / $374.95	Facility		$297.61	$337.55	$374.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $337.46 / $337.55 / $374.95	Professional		$337.46	$337.55	$374.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $328.32 / $421.08 / $732.32	Facility		$328.32	$421.08	$732.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $356.88 / $366.16 / $366.16	Facility		$356.88	$366.16	$366.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $297.86 / $318.70 / $412.45	Professional		$297.86	$318.70	$412.45
United Facility/Professional Professional Modifier Low / Median / High Price $168.40 / $241.59 / $321.29	Professional		$168.40	$241.59	$321.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $182.14 / $182.14 / $214.69	Professional		$182.14	$182.14	$214.69