Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.44 / $101.45 / $377.71	Facility		$64.44	$101.45	$377.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.58 / $64.44 / $101.45	Professional		$41.58	$64.44	$101.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $71.98 / $110.48 / $283.20	Facility		$71.98	$110.48	$283.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $58.27 / $133.74 / $514.13	Professional		$58.27	$133.74	$514.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.03 / $110.51 / $177.01	Facility		$34.03	$110.51	$177.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.58 / $72.34 / $93.36	Professional		$34.58	$72.34	$93.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $67.58 / $86.40 / $211.80	Facility		$67.58	$86.40	$211.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.55 / $100.77 / $189.50	Professional		$68.55	$100.77	$189.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.55 / $68.55 / $143.96	Facility		$68.55	$68.55	$143.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.55 / $110.48 / $205.65	Facility		$68.55	$110.48	$205.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.70 / $85.69 / $103.51	Professional		$61.70	$85.69	$103.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $71.98 / $112.49 / $188.51	Facility		$71.98	$112.49	$188.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $133.34 / $159.44	Professional		$75.81	$133.34	$159.44
United Facility/Professional Professional Modifier Low / Median / High Price $25.01 / $28.79 / $76.78	Professional		$25.01	$28.79	$76.78