Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.11 / $174.37 / $339.48	Facility		$159.11	$174.37	$339.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.41 / $165.90 / $197.48	Professional		$163.41	$165.90	$197.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $145.57 / $227.94 / $761.40	Facility		$145.57	$227.94	$761.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $180.68 / $3,623.57	Professional		$164.25	$180.68	$3,623.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.51 / $154.96 / $369.84	Facility		$152.51	$154.96	$369.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $201.44	Professional		$164.25	$164.25	$201.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $168.95 / $393.34	Facility		$131.90	$168.95	$393.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.56 / $164.45 / $321.93	Professional		$131.56	$164.45	$321.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $167.50 / $205.57	Professional		$75.00	$167.50	$205.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $163.21 / $185.95 / $341.64	Facility		$163.21	$185.95	$341.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.11 / $222.71 / $407.58	Facility		$124.11	$222.71	$407.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.13 / $194.22 / $351.04	Professional		$161.13	$194.22	$351.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $151.96 / $180.68 / $303.92	Facility		$151.96	$180.68	$303.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $180.68 / $197.10	Professional		$164.25	$180.68	$197.10
United Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $197.10	Professional		$164.25	$164.25	$197.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $152.51 / $164.25 / $164.25	Professional		$152.51	$164.25	$164.25