Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Facility		$151.27	$151.27	$151.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.38 / $151.27 / $151.27	Professional		$142.38	$151.27	$151.27
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $147.72 / $169.07 / $667.39	Facility		$147.72	$169.07	$667.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $151.27 / $261.45 / $800.87	Professional		$151.27	$261.45	$800.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.27 / $151.27 / $302.54	Facility		$151.27	$151.27	$302.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Professional		$151.27	$151.27	$151.27
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 $304.83 / $304.83 / $304.83	Professional		$304.83	$304.83	$304.83
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 $152.90 / $183.65 / $186.26	Facility		$152.90	$183.65	$186.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.72 / $147.72 / $151.27	Facility		$147.72	$147.72	$151.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.04 / $151.27 / $160.16	Professional		$137.04	$151.27	$160.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.29 / $182.76 / $249.70	Professional		$162.29	$182.76	$249.70
United Facility/Professional Professional Modifier Low / Median / High Price $161.79 / $161.79 / $194.15	Professional		$161.79	$161.79	$194.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $10.68 / $10.68 / $10.68	Professional		$10.68	$10.68	$10.68