Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.13 / $188.71 / $197.02	Facility		$83.13	$188.71	$197.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.09 / $83.13 / $199.14	Professional		$63.09	$83.13	$199.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $128.47 / $689.27 / $689.27	Facility		$128.47	$689.27	$689.27
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $102.71 / $129.59 / $730.72	Professional		$102.71	$129.59	$730.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.15 / $88.15 / $88.15	Facility		$88.15	$88.15	$88.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.93 / $74.93 / $108.90	Professional		$74.93	$74.93	$108.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $86.54 / $149.60 / $252.16	Facility		$86.54	$149.60	$252.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.42 / $149.66 / $264.80	Professional		$87.42	$149.66	$264.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $75.00 / $146.72	Professional		$60.00	$75.00	$146.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $116.48 / $143.29 / $146.72	Facility		$116.48	$143.29	$146.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $128.22 / $146.72 / $146.72	Professional		$128.22	$146.72	$146.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.80 / $128.47 / $237.57	Facility		$121.80	$128.47	$237.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.80 / $132.68 / $164.78	Professional		$121.80	$132.68	$164.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $116.57 / $124.72 / $161.40	Professional		$116.57	$124.72	$161.40
United Facility/Professional Facility Modifier Low / Median / High Price $52.74 / $62.33 / $97.64	Facility		$52.74	$62.33	$97.64
United Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $62.33 / $118.71	Professional		$57.53	$62.33	$118.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.99 / $85.99 / $93.64	Professional		$85.99	$85.99	$93.64