Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.87 / $242.67 / $675.55	Facility		$124.87	$242.67	$675.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.41 / $117.38 / $198.93	Professional		$87.41	$117.38	$198.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $131.11 / $199.79 / $883.04	Facility		$131.11	$199.79	$883.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $112.38 / $243.65 / $936.53	Professional		$112.38	$243.65	$936.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.06 / $201.30 / $324.68	Facility		$62.06	$201.30	$324.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.08 / $131.90 / $170.20	Professional		$60.08	$131.90	$170.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $123.38 / $157.94 / $386.32	Facility		$123.38	$157.94	$386.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.87 / $183.56 / $345.64	Professional		$124.87	$183.56	$345.64
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 $124.87 / $124.87 / $262.23	Facility		$124.87	$124.87	$262.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.87 / $218.52 / $374.61	Facility		$124.87	$218.52	$374.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.38 / $156.09 / $188.55	Professional		$112.38	$156.09	$188.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.11 / $199.79 / $343.39	Facility		$131.11	$199.79	$343.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.11 / $243.11 / $290.25	Professional		$138.11	$243.11	$290.25
United Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $52.45 / $139.85	Professional		$52.45	$52.45	$139.85