Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $214.58 / $487.10 / $508.56	Facility		$214.58	$487.10	$508.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.48 / $214.58 / $508.56	Professional		$200.48	$214.58	$508.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $289.13 / $628.78 / $1,614.69	Facility		$289.13	$628.78	$1,614.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $231.13 / $287.27 / $1,996.78	Professional		$231.13	$287.27	$1,996.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.68 / $225.68 / $225.68	Facility		$225.68	$225.68	$225.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.75 / $164.75 / $225.68	Professional		$164.75	$164.75	$225.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $189.28 / $330.19 / $861.56	Facility		$189.28	$330.19	$861.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $189.48 / $332.67 / $638.00	Professional		$189.48	$332.67	$638.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $227.81 / $253.13 / $278.44	Professional		$227.81	$253.13	$278.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $297.17 / $330.19 / $400.96	Facility		$297.17	$330.19	$400.96
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $262.31 / $262.31 / $262.31	Professional		$262.31	$262.31	$262.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $289.13 / $370.82 / $644.90	Facility		$289.13	$370.82	$644.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $314.27 / $322.45 / $322.45	Facility		$314.27	$322.45	$322.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $262.31 / $280.66 / $363.21	Professional		$262.31	$280.66	$363.21
United Facility/Professional Professional Modifier Low / Median / High Price $150.02 / $225.04 / $286.23	Professional		$150.02	$225.04	$286.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.35 / $85.35 / $280.66	Professional		$85.35	$85.35	$280.66