Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.53 / $115.53 / $173.30	Facility		$115.53	$115.53	$173.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.22 / $76.33 / $115.53	Professional		$58.22	$76.33	$115.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $83.30 / $129.43 / $426.26	Facility		$83.30	$129.43	$426.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $93.65 / $231.71 / $832.58	Professional		$93.65	$231.71	$832.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.98 / $6.57 / $154.43	Facility		$2.98	$6.57	$154.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.83 / $89.31 / $127.76	Professional		$38.83	$89.31	$127.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.40 / $117.25 / $225.76	Facility		$69.40	$117.25	$225.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.58 / $125.19 / $244.11	Professional		$73.58	$125.19	$244.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $44.00 / $75.00	Professional		$40.00	$44.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $118.25 / $142.03 / $191.62	Facility		$118.25	$142.03	$191.62
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $157.30 / $157.30 / $157.30	Professional		$157.30	$157.30	$157.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.65 / $93.65 / $93.65	Professional		$93.65	$93.65	$93.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $82.93 / $113.65 / $216.12	Facility		$82.93	$113.65	$216.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $133.97 / $187.06 / $245.67	Professional		$133.97	$187.06	$245.67
United Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $43.35 / $103.22	Professional		$31.66	$43.35	$103.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $42.05 / $42.05	Professional		$42.05	$42.05	$42.05