Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Facility		$205.70	$205.70	$205.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.60 / $205.70 / $205.70	Professional		$193.60	$205.70	$205.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $200.86 / $229.90 / $907.50	Facility		$200.86	$229.90	$907.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $143.78 / $220.49 / $1,089.00	Professional		$143.78	$220.49	$1,089.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.70 / $205.70 / $411.40	Facility		$205.70	$205.70	$411.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Professional		$205.70	$205.70	$205.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.45 / $65.51 / $118.95	Facility		$47.45	$65.51	$118.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $273.02 / $273.02 / $273.02	Professional		$273.02	$273.02	$273.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $50.00	Professional		$45.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $136.94 / $164.49 / $166.83	Facility		$136.94	$164.49	$166.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $200.86 / $200.86 / $205.70	Facility		$200.86	$200.86	$205.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.34 / $205.70 / $217.80	Professional		$186.34	$205.70	$217.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.93 / $164.86 / $220.49	Professional		$141.93	$164.86	$220.49
United Facility/Professional Professional Modifier Low / Median / High Price $220.00 / $220.00 / $264.00	Professional		$220.00	$220.00	$264.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.49 / $38.49 / $38.49	Professional		$38.49	$38.49	$38.49