Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.29 / $336.00 / $616.17	Facility		$128.29	$336.00	$616.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $112.35 / $164.98	Professional		$67.98	$112.35	$164.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $134.69 / $224.51 / $530.02	Facility		$134.69	$224.51	$530.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $115.46 / $263.00 / $962.18	Professional		$115.46	$263.00	$962.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.41 / $272.70 / $411.80	Facility		$133.41	$272.70	$411.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.06 / $143.93 / $185.14	Professional		$80.06	$143.93	$185.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $128.29 / $188.85 / $396.50	Facility		$128.29	$188.85	$396.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.29 / $226.80 / $396.50	Professional		$128.29	$226.80	$396.50
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 $128.29 / $128.29 / $269.41	Facility		$128.29	$128.29	$269.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.29 / $224.51 / $384.87	Facility		$128.29	$224.51	$384.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.46 / $160.36 / $193.72	Professional		$115.46	$160.36	$193.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $134.69 / $211.68 / $352.80	Facility		$134.69	$211.68	$352.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $149.58 / $249.85 / $297.99	Professional		$149.58	$249.85	$297.99
United Facility/Professional Professional Modifier Low / Median / High Price $53.88 / $73.31 / $143.68	Professional		$53.88	$73.31	$143.68