Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.79 / $177.79 / $177.79	Facility		$177.79	$177.79	$177.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $177.79 / $179.68	Professional		$161.62	$177.79	$179.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $401.99 / $1,674.94	Facility		$161.62	$401.99	$1,674.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $2,009.93	Professional		$161.62	$161.62	$2,009.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.47 / $152.47 / $337.84	Facility		$152.47	$152.47	$337.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $198.22	Professional		$161.62	$161.62	$198.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $161.62 / $218.19	Facility		$161.62	$161.62	$218.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $202.02	Professional		$161.62	$161.62	$202.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $164.84 / $335.45	Facility		$161.62	$164.84	$335.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $259.33 / $370.72 / $370.72	Facility		$259.33	$370.72	$370.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.39 / $210.70 / $332.26	Professional		$186.39	$210.70	$332.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $161.62 / $161.62	Facility		$161.62	$161.62	$161.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $153.54 / $161.62 / $161.62	Professional		$153.54	$161.62	$161.62
United Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $193.94	Professional		$161.62	$161.62	$193.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $171.81	Professional		$161.62	$161.62	$171.81