Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.97 / $250.27 / $379.34	Facility		$199.97	$250.27	$379.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.86 / $157.63 / $279.52	Professional		$114.86	$157.63	$279.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $136.40 / $196.15 / $591.88	Facility		$136.40	$196.15	$591.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $142.10 / $251.39 / $1,162.88	Professional		$142.10	$251.39	$1,162.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.02 / $261.27 / $421.19	Professional		$147.02	$261.27	$421.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $114.52 / $222.24 / $370.50	Facility		$114.52	$222.24	$370.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $126.84 / $200.65 / $362.72	Professional		$126.84	$200.65	$362.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.15 / $141.30 / $319.64	Professional		$30.15	$141.30	$319.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $192.83 / $258.45 / $294.44	Facility		$192.83	$258.45	$294.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $176.18 / $185.54 / $196.15	Facility		$176.18	$185.54	$196.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.88 / $310.54 / $380.54	Professional		$194.88	$310.54	$380.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $132.41 / $180.02 / $331.58	Facility		$132.41	$180.02	$331.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $151.55 / $300.38	Professional		$135.00	$151.55	$300.38
United Facility/Professional Professional Modifier Low / Median / High Price $170.50 / $255.23 / $421.01	Professional		$170.50	$255.23	$421.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.94 / $130.34 / $148.79	Professional		$107.94	$130.34	$148.79