Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $230.91 / $524.16 / $547.26	Facility		$230.91	$524.16	$547.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.81 / $230.91 / $547.26	Professional		$163.81	$230.91	$547.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $311.14 / $659.83 / $1,389.02	Facility		$311.14	$659.83	$1,389.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $189.22 / $302.02 / $1,758.88	Professional		$189.22	$302.02	$1,758.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.52 / $166.52 / $166.52	Facility		$166.52	$166.52	$166.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.56 / $121.56 / $166.52	Professional		$121.56	$121.56	$166.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $167.89 / $337.56 / $763.12	Facility		$167.89	$337.56	$763.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $168.07 / $337.56 / $565.17	Professional		$168.07	$337.56	$565.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $245.16 / $272.41 / $299.65	Professional		$245.16	$272.41	$299.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $282.05 / $327.61 / $355.33	Facility		$282.05	$327.61	$355.33
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $319.80 / $355.33 / $355.33	Professional		$319.80	$355.33	$355.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $311.14 / $399.06 / $694.02	Facility		$311.14	$399.06	$694.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $338.21 / $347.01 / $347.01	Facility		$338.21	$347.01	$347.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $282.29 / $302.02 / $390.86	Professional		$282.29	$302.02	$390.86
United Facility/Professional Professional Modifier Low / Median / High Price $132.94 / $199.43 / $253.66	Professional		$132.94	$199.43	$253.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.58 / $128.58 / $175.88	Professional		$128.58	$128.58	$175.88