Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.40 / $309.63 / $323.27	Facility		$136.40	$309.63	$323.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $136.40 / $323.27	Professional		$101.72	$136.40	$323.27
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $183.79 / $452.71 / $1,046.34	Facility		$183.79	$452.71	$1,046.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $153.22 / $187.32 / $1,431.09	Professional		$153.22	$187.32	$1,431.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.35 / $172.35 / $172.35	Facility		$172.35	$172.35	$172.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.82 / $125.82 / $172.35	Professional		$125.82	$125.82	$172.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.58 / $214.32 / $572.80	Facility		$125.58	$214.32	$572.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.71 / $214.32 / $423.68	Professional		$125.71	$214.32	$423.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $144.81 / $160.90 / $176.99	Professional		$144.81	$160.90	$176.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $166.61 / $203.44 / $209.89	Facility		$166.61	$203.44	$209.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $203.44 / $209.89 / $209.89	Professional		$203.44	$209.89	$209.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.79 / $235.72 / $409.94	Facility		$183.79	$235.72	$409.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $199.78 / $204.97 / $204.97	Facility		$199.78	$204.97	$204.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $166.74 / $178.41 / $230.88	Professional		$166.74	$178.41	$230.88
United Facility/Professional Facility Modifier Low / Median / High Price $76.81 / $131.74 / $153.62	Facility		$76.81	$131.74	$153.62
United Facility/Professional Professional Modifier Low / Median / High Price $95.25 / $132.91 / $190.20	Professional		$95.25	$132.91	$190.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.24 / $57.24 / $178.41	Professional		$57.24	$57.24	$178.41