Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.30 / $168.33 / $798.56	Facility		$81.30	$168.33	$798.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.66 / $81.30 / $183.37	Professional		$55.66	$81.30	$183.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $564.38 / $1,102.42	Facility		$55.00	$564.38	$1,102.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $101.14 / $175.13 / $632.48	Professional		$101.14	$175.13	$632.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.37 / $47.37 / $78.92	Facility		$47.37	$47.37	$78.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.97 / $146.74 / $223.87	Professional		$89.97	$146.74	$223.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $65.70 / $143.91 / $411.03	Facility		$65.70	$143.91	$411.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $135.84 / $182.05	Professional		$66.34	$135.84	$182.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.98 / $68.73 / $151.62	Professional		$9.98	$68.73	$151.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.47 / $134.00 / $144.05	Facility		$99.47	$134.00	$144.05
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $44.75 / $44.75 / $44.75	Professional		$44.75	$44.75	$44.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.89 / $94.22 / $98.26	Facility		$34.89	$94.22	$98.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.89 / $161.69 / $201.52	Professional		$101.89	$161.69	$201.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $366.18 / $564.38 / $1,080.21	Facility		$366.18	$564.38	$1,080.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $96.10 / $139.85 / $190.38	Professional		$96.10	$139.85	$190.38
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $152.40 / $214.05	Professional		$90.00	$152.40	$214.05