Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.72 / $238.26 / $326.39	Facility		$137.72	$238.26	$326.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.24 / $137.72 / $161.38	Professional		$131.24	$137.72	$161.38
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $137.72 / $153.91	Facility		$85.00	$137.72	$153.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $138.53 / $153.91 / $324.04	Professional		$138.53	$153.91	$324.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.72 / $137.72 / $275.44	Facility		$137.72	$137.72	$275.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.72 / $137.72 / $137.72	Professional		$137.72	$137.72	$137.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $29.28 / $56.79 / $76.87	Facility		$29.28	$56.79	$76.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.28 / $57.09 / $291.70	Professional		$29.28	$57.09	$291.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $169.31	Professional		$75.00	$75.00	$169.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $37.40 / $45.56 / $45.56	Facility		$37.40	$45.56	$45.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $153.91 / $153.91 / $153.91	Facility		$153.91	$153.91	$153.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.91 / $153.91 / $153.91	Professional		$153.91	$153.91	$153.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $153.91 / $153.91 / $153.91	Facility		$153.91	$153.91	$153.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $146.22 / $153.91 / $153.91	Professional		$146.22	$153.91	$153.91
United Facility/Professional Professional Modifier Low / Median / High Price $153.91 / $153.91 / $153.91	Professional		$153.91	$153.91	$153.91