Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.83 / $483.74 / $503.09	Facility		$269.83	$483.74	$503.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $269.83 / $272.52	Professional		$245.30	$269.83	$272.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $245.30 / $395.99 / $1,071.67	Facility		$245.30	$395.99	$1,071.67
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $233.04 / $245.30 / $1,071.67	Professional		$233.04	$245.30	$1,071.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $231.42 / $231.42 / $494.04	Facility		$231.42	$231.42	$494.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $245.30 / $300.83	Professional		$245.30	$245.30	$300.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.30 / $245.30 / $627.69	Facility		$245.30	$245.30	$627.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $245.30 / $652.63	Professional		$245.30	$245.30	$652.63
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 $241.87 / $245.30 / $463.62	Facility		$241.87	$245.30	$463.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $286.23 / $406.28 / $406.28	Facility		$286.23	$406.28	$406.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.33 / $286.23 / $469.43	Professional		$263.33	$286.23	$469.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $245.30 / $245.30 / $245.30	Facility		$245.30	$245.30	$245.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $233.04 / $245.30 / $245.30	Professional		$233.04	$245.30	$245.30
United Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $245.30 / $294.36	Professional		$245.30	$245.30	$294.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $242.73 / $245.30 / $245.30	Professional		$242.73	$245.30	$245.30