Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.28 / $157.04 / $217.53	Facility		$98.28	$157.04	$217.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $93.81 / $153.91	Professional		$89.34	$93.81	$153.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $115.76 / $211.94 / $593.75	Facility		$115.76	$211.94	$593.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $98.27 / $1,160.52	Professional		$89.34	$98.27	$1,160.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.29 / $89.34 / $323.30	Facility		$84.29	$89.34	$323.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $122.18	Professional		$89.34	$89.34	$122.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $127.99 / $347.92	Facility		$89.34	$127.99	$347.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $128.97 / $286.83	Professional		$89.34	$128.97	$286.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $115.03 / $130.62	Professional		$75.00	$115.03	$130.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $111.68 / $242.11	Facility		$89.34	$111.68	$242.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $205.05 / $375.25	Facility		$120.62	$205.05	$375.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.86 / $169.79 / $306.88	Professional		$140.86	$169.79	$306.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $98.27 / $162.47 / $282.58	Facility		$98.27	$162.47	$282.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $98.27 / $107.21	Professional		$89.34	$98.27	$107.21
United Facility/Professional Facility Modifier Low / Median / High Price $279.06 / $279.06 / $279.06	Facility		$279.06	$279.06	$279.06
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $107.21	Professional		$89.34	$89.34	$107.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $133.32	Professional		$89.34	$89.34	$133.32