Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.87 / $126.87 / $126.87	Facility		$126.87	$126.87	$126.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $126.87 / $162.91	Professional		$55.09	$126.87	$162.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $197.96 / $348.93 / $348.93	Facility		$197.96	$348.93	$348.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $95.97 / $254.07 / $935.43	Professional		$95.97	$254.07	$935.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.26 / $128.26 / $128.26	Professional		$128.26	$128.26	$128.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $53.50 / $125.55 / $220.72	Facility		$53.50	$125.55	$220.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.50 / $123.20 / $215.86	Professional		$53.50	$123.20	$215.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.94 / $147.81 / $268.76	Professional		$120.94	$147.81	$268.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.13 / $270.14 / $294.80	Facility		$142.13	$270.14	$294.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $197.96 / $197.96 / $197.96	Facility		$197.96	$197.96	$197.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.35 / $239.75 / $391.44	Professional		$125.35	$239.75	$391.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $292.94 / $292.94 / $292.94	Facility		$292.94	$292.94	$292.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $194.48 / $246.81 / $362.91	Professional		$194.48	$246.81	$362.91
United Facility/Professional Professional Modifier Low / Median / High Price $169.26 / $261.54 / $394.76	Professional		$169.26	$261.54	$394.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $118.98 / $141.81 / $141.81	Professional		$118.98	$141.81	$141.81