Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.89 / $281.67 / $813.79	Facility		$114.89	$281.67	$813.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.56 / $125.62 / $385.35	Professional		$98.56	$125.62	$385.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $128.33 / $213.89 / $427.77	Facility		$128.33	$213.89	$427.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $239.02 / $916.65	Professional		$110.00	$239.02	$916.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.12 / $221.66 / $357.48	Facility		$62.12	$221.66	$357.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.25 / $137.36 / $187.24	Professional		$76.25	$137.36	$187.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $179.94 / $419.06	Facility		$122.22	$179.94	$419.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $216.00 / $378.70	Professional		$122.22	$216.00	$378.70
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 $122.22 / $122.22 / $256.66	Facility		$122.22	$122.22	$256.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $213.89 / $366.66	Facility		$110.00	$213.89	$366.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $152.78 / $184.55	Professional		$110.00	$152.78	$184.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.33 / $201.66 / $336.11	Facility		$128.33	$201.66	$336.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $142.51 / $237.73 / $284.06	Professional		$142.51	$237.73	$284.06
United Facility/Professional Facility Modifier Low / Median / High Price $92.21 / $122.22 / $122.22	Facility		$92.21	$122.22	$122.22
United Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $51.33 / $136.88	Professional		$51.33	$51.33	$136.88