Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.59 / $244.31 / $627.73	Facility		$129.59	$244.31	$627.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.38 / $99.72 / $252.06	Professional		$69.38	$99.72	$252.06
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $148.44 / $222.36 / $508.62	Facility		$148.44	$222.36	$508.62
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $199.97 / $932.40	Professional		$109.44	$199.97	$932.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $106.00 / $115.00	Facility		$60.00	$106.00	$115.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.88 / $165.86 / $337.40	Professional		$95.88	$165.86	$337.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $81.06 / $126.49 / $253.17	Facility		$81.06	$126.49	$253.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.04 / $124.32 / $234.57	Professional		$81.04	$124.32	$234.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.84 / $150.94 / $267.34	Professional		$27.84	$150.94	$267.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $134.27 / $183.70 / $223.78	Facility		$134.27	$183.70	$223.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $149.04 / $200.02 / $295.58	Facility		$149.04	$200.02	$295.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.63 / $239.84 / $290.61	Professional		$152.63	$239.84	$290.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $139.16 / $166.77 / $237.18	Facility		$139.16	$166.77	$237.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.47 / $115.23 / $194.53	Professional		$109.47	$115.23	$194.53
United Facility/Professional Facility Modifier Low / Median / High Price $97.81 / $119.55 / $119.55	Facility		$97.81	$119.55	$119.55
United Facility/Professional Professional Modifier Low / Median / High Price $108.68 / $138.85 / $301.77	Professional		$108.68	$138.85	$301.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $110.52 / $120.89 / $120.89	Professional		$110.52	$120.89	$120.89