Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.15 / $163.15 / $295.55	Facility		$163.15	$163.15	$295.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.66 / $126.24 / $163.15	Professional		$82.66	$126.24	$163.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $212.64 / $332.20 / $755.40	Facility		$212.64	$332.20	$755.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $146.91 / $274.45 / $1,435.50	Professional		$146.91	$274.45	$1,435.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $108.00 / $115.00	Facility		$106.00	$108.00	$115.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $191.32 / $468.59	Professional		$125.83	$191.32	$468.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $122.85 / $178.36 / $404.42	Facility		$122.85	$178.36	$404.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.44 / $179.29 / $368.78	Professional		$125.44	$179.29	$368.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $219.38 / $327.00 / $334.33	Facility		$219.38	$327.00	$334.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.16 / $226.95 / $226.95	Facility		$168.16	$226.95	$226.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $226.95 / $315.16 / $421.33	Professional		$226.95	$315.16	$421.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $212.64 / $249.15 / $388.61	Facility		$212.64	$249.15	$388.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $163.55 / $172.85 / $286.81	Professional		$163.55	$172.85	$286.81
United Facility/Professional Professional Modifier Low / Median / High Price $134.34 / $167.09 / $422.32	Professional		$134.34	$167.09	$422.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $108.43 / $108.43 / $108.43	Professional		$108.43	$108.43	$108.43