Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.54 / $178.35 / $247.21	Facility		$135.54	$178.35	$247.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.11 / $137.78 / $261.77	Professional		$76.11	$137.78	$261.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $87.77 / $713.37 / $1,455.83	Facility		$87.77	$713.37	$1,455.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $129.59 / $212.53 / $795.04	Professional		$129.59	$212.53	$795.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.13 / $137.13 / $137.13	Facility		$137.13	$137.13	$137.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.59 / $164.32 / $303.67	Professional		$93.59	$164.32	$303.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $86.70 / $156.69 / $263.12	Facility		$86.70	$156.69	$263.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $156.69 / $256.70	Professional		$86.70	$156.69	$256.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $151.02 / $268.41	Professional		$27.30	$151.02	$268.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.01 / $178.75 / $217.75	Facility		$123.01	$178.75	$217.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.64 / $141.79 / $148.53	Facility		$40.64	$141.79	$148.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.19 / $189.43 / $265.52	Professional		$127.19	$189.43	$265.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $493.52 / $761.06 / $1,455.83	Facility		$493.52	$761.06	$1,455.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $118.65 / $172.86 / $256.13	Professional		$118.65	$172.86	$256.13
United Facility/Professional Facility Modifier Low / Median / High Price $151.00 / $648.00 / $5,793.00	Facility		$151.00	$648.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $122.40 / $174.41 / $304.95	Professional		$122.40	$174.41	$304.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.37 / $91.10 / $120.05	Professional		$81.37	$91.10	$120.05