Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.11 / $86.11 / $86.11	Facility		$86.11	$86.11	$86.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.25 / $86.11 / $209.70	Professional		$82.25	$86.11	$209.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $138.68 / $300.32 / $725.63	Facility		$138.68	$300.32	$725.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $21.98 / $113.17 / $200.00	Professional		$21.98	$113.17	$200.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.50 / $123.50 / $123.50	Facility		$123.50	$123.50	$123.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.35 / $121.41 / $132.84	Professional		$12.35	$121.41	$132.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $142.84 / $142.84 / $142.84	Facility		$142.84	$142.84	$142.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $142.84 / $142.84 / $142.84	Professional		$142.84	$142.84	$142.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $163.99 / $204.99 / $225.48	Professional		$163.99	$204.99	$225.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.84 / $164.49 / $215.93	Facility		$142.84	$164.49	$215.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $142.84 / $164.49 / $215.93	Professional		$142.84	$164.49	$215.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.11 / $151.09 / $302.18	Facility		$15.11	$151.09	$302.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.79 / $134.52 / $304.52	Professional		$11.79	$134.52	$304.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $138.68 / $138.68 / $164.61	Facility		$138.68	$138.68	$164.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $18.05 / $18.05 / $21.98	Professional		$18.05	$18.05	$21.98
United Facility/Professional Professional Modifier Low / Median / High Price $78.36 / $96.10 / $150.51	Professional		$78.36	$96.10	$150.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $130.10 / $130.10 / $130.10	Professional		$130.10	$130.10	$130.10