Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.73 / $267.64 / $624.10	Facility		$170.73	$267.64	$624.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.14 / $102.79 / $170.73	Professional		$61.14	$102.79	$170.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $121.13 / $223.80 / $547.96	Facility		$121.13	$223.80	$547.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $59.99 / $132.97 / $638.40	Professional		$59.99	$132.97	$638.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.48 / $209.21 / $297.86	Facility		$79.48	$209.21	$297.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $132.57 / $181.59	Professional		$72.06	$132.57	$181.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $115.36 / $169.58 / $356.68	Facility		$115.36	$169.58	$356.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $115.36 / $203.68 / $356.68	Professional		$115.36	$203.68	$356.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $115.36	Professional		$75.00	$75.00	$115.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $115.36 / $115.36 / $242.26	Facility		$115.36	$115.36	$242.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.36 / $173.04 / $317.24	Facility		$115.36	$173.04	$317.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.82 / $138.43 / $163.81	Professional		$103.82	$138.43	$163.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $132.66 / $190.34 / $317.24	Facility		$132.66	$190.34	$317.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.54 / $203.17 / $282.20	Professional		$104.54	$203.17	$282.20
United Facility/Professional Facility Modifier Low / Median / High Price $74.98 / $109.59 / $115.36	Facility		$74.98	$109.59	$115.36
United Facility/Professional Professional Modifier Low / Median / High Price $48.45 / $48.45 / $129.19	Professional		$48.45	$48.45	$129.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.91 / $51.91 / $59.76	Professional		$51.91	$51.91	$59.76