Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.27 / $206.81 / $657.98	Facility		$95.27	$206.81	$657.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.03 / $95.27 / $102.33	Professional		$93.03	$95.27	$102.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.87 / $106.48 / $420.30	Facility		$100.87	$106.48	$420.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $106.48 / $106.48 / $504.36	Professional		$106.48	$106.48	$504.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.27 / $95.27 / $190.54	Facility		$95.27	$95.27	$190.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $95.27 / $95.27	Professional		$95.27	$95.27	$95.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $101.99 / $243.84 / $295.01	Facility		$101.99	$243.84	$295.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.99 / $243.84 / $315.37	Professional		$101.99	$243.84	$315.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $117.12	Professional		$75.00	$75.00	$117.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $106.48 / $106.48 / $206.36	Facility		$106.48	$106.48	$206.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.48 / $106.48 / $106.48	Facility		$106.48	$106.48	$106.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.48 / $106.48 / $106.48	Professional		$106.48	$106.48	$106.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $106.48 / $106.48 / $106.48	Facility		$106.48	$106.48	$106.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $101.16 / $106.48 / $106.48	Professional		$101.16	$106.48	$106.48
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $120.00	Professional		$100.00	$100.00	$120.00