Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $89.31 / $210.14	Facility		$89.31	$89.31	$210.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.06 / $89.31 / $89.31	Professional		$84.06	$89.31	$89.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $87.56 / $133.74 / $445.80	Facility		$87.56	$133.74	$445.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $89.31 / $472.82	Professional		$87.56	$89.31	$472.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.16 / $89.16 / $216.21	Facility		$89.16	$89.16	$216.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Professional		$89.31	$89.31	$89.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $82.37 / $178.32 / $390.32	Facility		$82.37	$178.32	$390.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $98.08 / $160.00 / $229.85	Professional		$98.08	$160.00	$229.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $87.56 / $105.07	Professional		$50.00	$87.56	$105.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $115.44 / $79,999.20 / $79,999.20	Facility		$115.44	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.43 / $89.31 / $200.51	Facility		$74.43	$89.31	$200.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $89.31 / $110.32	Professional		$80.90	$89.31	$110.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $89.16 / $106.99 / $192.88	Facility		$89.16	$106.99	$192.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $84.84 / $89.31 / $89.31	Professional		$84.84	$89.31	$89.31
United Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $87.56 / $105.07	Professional		$87.56	$87.56	$105.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $82.42 / $82.42 / $87.56	Professional		$82.42	$82.42	$87.56