Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.69 / $378.39 / $395.06	Facility		$166.69	$378.39	$395.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.17 / $166.69 / $395.06	Professional		$117.17	$166.69	$395.06
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $224.61 / $488.47 / $1,083.05	Facility		$224.61	$488.47	$1,083.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $163.80 / $223.16 / $1,269.72	Professional		$163.80	$223.16	$1,269.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $175.58 / $175.58 / $175.58	Facility		$175.58	$175.58	$175.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.16 / $128.16 / $175.58	Professional		$128.16	$128.16	$175.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $131.04 / $250.39 / $597.17	Facility		$131.04	$250.39	$597.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.18 / $245.72 / $442.71	Professional		$131.18	$245.72	$442.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $176.98 / $196.65 / $216.31	Professional		$176.98	$196.65	$216.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $203.61 / $234.33 / $256.51	Facility		$203.61	$234.33	$256.51
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $203.78 / $256.51 / $256.51	Professional		$203.78	$256.51	$256.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $224.61 / $288.08 / $501.00	Facility		$224.61	$288.08	$501.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $244.15 / $250.50 / $250.50	Facility		$244.15	$250.50	$250.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $203.78 / $218.03 / $282.16	Professional		$203.78	$218.03	$282.16
United Facility/Professional Professional Modifier Low / Median / High Price $104.02 / $156.69 / $198.46	Professional		$104.02	$156.69	$198.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.38 / $137.38 / $218.03	Professional		$137.38	$137.38	$218.03