Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.23 / $490.84 / $512.47	Facility		$216.23	$490.84	$512.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.76 / $216.23 / $512.47	Professional		$171.76	$216.23	$512.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $291.36 / $633.63 / $1,599.48	Facility		$291.36	$633.63	$1,599.48
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $238.49 / $291.18 / $1,710.73	Professional		$238.49	$291.18	$1,710.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $220.51 / $220.51 / $220.51	Facility		$220.51	$220.51	$220.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.97 / $160.97 / $220.51	Professional		$160.97	$160.97	$220.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $192.92 / $332.74 / $876.56	Facility		$192.92	$332.74	$876.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $193.13 / $339.07 / $650.41	Professional		$193.13	$339.07	$650.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $229.58 / $255.09 / $280.59	Professional		$229.58	$255.09	$280.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $264.13 / $324.94 / $343.52	Facility		$264.13	$324.94	$343.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $264.33 / $332.74 / $343.52	Professional		$264.33	$332.74	$343.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $291.36 / $373.68 / $649.88	Facility		$291.36	$373.68	$649.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $316.70 / $324.94 / $324.94	Facility		$316.70	$324.94	$324.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $264.33 / $282.83 / $366.01	Professional		$264.33	$282.83	$366.01
United Facility/Professional Professional Modifier Low / Median / High Price $152.90 / $229.35 / $291.70	Professional		$152.90	$229.35	$291.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $174.90 / $174.90 / $187.23	Professional		$174.90	$174.90	$187.23