Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.85 / $219.62 / $291.83	Facility		$128.85	$219.62	$291.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $111.10 / $253.07	Professional		$92.03	$111.10	$253.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $130.91 / $222.26 / $438.98	Facility		$130.91	$222.26	$438.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $115.42 / $183.23 / $802.80	Professional		$115.42	$183.23	$802.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $106.00 / $120.00	Facility		$60.00	$106.00	$120.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.70 / $161.41 / $283.20	Professional		$96.70	$161.41	$283.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $80.66 / $123.20 / $254.87	Facility		$80.66	$123.20	$254.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.39 / $126.62 / $234.89	Professional		$84.39	$126.62	$234.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $148.90 / $265.92	Professional		$27.89	$148.90	$265.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $140.01 / $191.84 / $203.68	Facility		$140.01	$191.84	$203.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $130.91 / $172.15 / $254.40	Facility		$130.91	$172.15	$254.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.47 / $207.34 / $257.70	Professional		$135.47	$207.34	$257.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $122.84 / $143.81 / $273.23	Facility		$122.84	$143.81	$273.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.94 / $133.52 / $170.24	Professional		$117.94	$133.52	$170.24
United Facility/Professional Facility Modifier Low / Median / High Price $93.80 / $93.80 / $105.14	Facility		$93.80	$93.80	$105.14
United Facility/Professional Professional Modifier Low / Median / High Price $93.80 / $145.44 / $279.99	Professional		$93.80	$145.44	$279.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.23 / $103.71 / $103.71	Professional		$95.23	$103.71	$103.71