Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.58 / $224.55 / $601.30	Facility		$102.58	$224.55	$601.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.41 / $103.96 / $224.55	Professional		$69.41	$103.96	$224.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $114.59 / $190.98 / $450.86	Facility		$114.59	$190.98	$450.86
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $96.77 / $202.86 / $818.48	Professional		$96.77	$202.86	$818.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.28 / $197.91 / $319.19	Facility		$48.28	$197.91	$319.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $122.42 / $167.16	Professional		$68.06	$122.42	$167.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $109.13 / $160.41 / $373.12	Facility		$109.13	$160.41	$373.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.13 / $193.05 / $337.20	Professional		$109.13	$193.05	$337.20
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 $109.13 / $109.13 / $229.17	Facility		$109.13	$109.13	$229.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.13 / $190.98 / $327.39	Facility		$109.13	$190.98	$327.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.22 / $136.41 / $164.79	Professional		$98.22	$136.41	$164.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $114.59 / $180.06 / $300.11	Facility		$114.59	$180.06	$300.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $127.24 / $212.14 / $253.87	Professional		$127.24	$212.14	$253.87
United Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $45.83 / $122.23	Professional		$45.83	$45.83	$122.23