Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.52 / $110.10 / $208.62	Facility		$99.52	$110.10	$208.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $101.09 / $121.36	Professional		$100.09	$101.09	$121.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $92.37 / $142.10 / $485.70	Facility		$92.37	$142.10	$485.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $110.10 / $428.03	Professional		$100.09	$110.10	$428.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.42 / $96.95 / $235.10	Facility		$94.42	$96.95	$235.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $122.75	Professional		$100.09	$100.09	$122.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.68 / $121.48 / $227.26	Facility		$85.68	$121.48	$227.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.34 / $120.22 / $214.44	Professional		$81.34	$120.22	$214.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $106.85 / $131.13	Professional		$75.00	$106.85	$131.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $113.55 / $251.00	Facility		$100.09	$113.55	$251.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.13 / $142.94 / $258.63	Facility		$83.13	$142.94	$258.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.44 / $123.47 / $223.16	Professional		$102.44	$123.47	$223.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $94.73 / $113.21 / $200.67	Facility		$94.73	$113.21	$200.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $110.10 / $120.10	Professional		$100.09	$110.10	$120.10
United Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $120.11	Professional		$100.09	$100.09	$120.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $96.95 / $100.09 / $100.09	Professional		$96.95	$100.09	$100.09