Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.97 / $111.31 / $219.81	Professional		$87.97	$111.31	$219.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $188.53 / $886.11 / $886.11	Facility		$188.53	$886.11	$886.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $105.16 / $148.43 / $273.81	Professional		$105.16	$148.43	$273.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.59 / $123.59 / $123.59	Facility		$123.59	$123.59	$123.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $123.59 / $162.21	Professional		$105.05	$123.59	$162.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $194.19 / $194.19 / $194.19	Facility		$194.19	$194.19	$194.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.19 / $194.19 / $194.19	Professional		$194.19	$194.19	$194.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $243.37 / $267.70	Professional		$75.00	$243.37	$267.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $175.94 / $194.19 / $310.02	Facility		$175.94	$194.19	$310.02
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $175.94 / $194.19 / $260.77	Professional		$175.94	$194.19	$260.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.55 / $195.33 / $216.81	Facility		$19.55	$195.33	$216.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.02 / $160.25 / $216.81	Professional		$16.02	$160.25	$216.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $188.53 / $188.53 / $188.53	Facility		$188.53	$188.53	$188.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $21.50 / $21.50 / $26.18	Professional		$21.50	$21.50	$26.18
United Facility/Professional Professional Modifier Low / Median / High Price $95.59 / $141.16 / $183.63	Professional		$95.59	$141.16	$183.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $215.84 / $215.84 / $215.84	Professional		$215.84	$215.84	$215.84