Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.29 / $269.66 / $523.40	Facility		$89.29	$269.66	$523.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $89.29 / $142.43	Professional		$47.50	$89.29	$142.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $99.74 / $166.23 / $392.44	Facility		$99.74	$166.23	$392.44
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $71.23 / $176.40 / $712.43	Professional		$71.23	$176.40	$712.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.73 / $154.35 / $245.26	Facility		$96.73	$154.35	$245.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.20 / $106.48 / $134.66	Professional		$50.20	$106.48	$134.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $93.93 / $118.74 / $271.70	Facility		$93.93	$118.74	$271.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.99 / $139.63 / $262.26	Professional		$94.99	$139.63	$262.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $92.99 / $100.80	Professional		$75.00	$92.99	$100.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $94.99 / $94.99 / $199.48	Facility		$94.99	$94.99	$199.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.99 / $170.98 / $284.97	Facility		$94.99	$170.98	$284.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.49 / $118.74 / $143.43	Professional		$85.49	$118.74	$143.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $99.74 / $155.88 / $261.22	Facility		$99.74	$155.88	$261.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $105.06 / $184.53 / $220.59	Professional		$105.06	$184.53	$220.59
United Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $39.90 / $106.39	Professional		$39.90	$39.90	$106.39