Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.65 / $150.60 / $227.23	Facility		$89.65	$150.60	$227.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.30 / $86.20 / $180.96	Professional		$65.30	$86.20	$180.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $99.96 / $156.46 / $307.29	Facility		$99.96	$156.46	$307.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $92.31 / $159.90 / $562.50	Professional		$92.31	$159.90	$562.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $127.07 / $222.44	Professional		$73.44	$127.07	$222.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $186.27 / $275.72 / $663.38	Facility		$186.27	$275.72	$663.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $192.93 / $192.93 / $228.46	Professional		$192.93	$192.93	$228.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.93 / $135.42 / $183.74	Professional		$98.93	$135.42	$183.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.01 / $154.06 / $161.84	Facility		$102.01	$154.06	$161.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.40 / $109.17 / $109.17	Facility		$107.40	$109.17	$109.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.21 / $153.97 / $198.07	Professional		$106.21	$153.97	$198.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $99.96 / $117.35 / $214.38	Facility		$99.96	$117.35	$214.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $94.71 / $129.34 / $182.35	Professional		$94.71	$129.34	$182.35
United Facility/Professional Professional Modifier Low / Median / High Price $75.69 / $124.27 / $227.84	Professional		$75.69	$124.27	$227.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.18 / $71.14 / $83.38	Professional		$66.18	$71.14	$83.38