Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.27 / $153.13 / $288.43	Facility		$122.27	$153.13	$288.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $140.60 / $167.79	Professional		$139.21	$140.60	$167.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $128.07 / $199.74 / $681.05	Facility		$128.07	$199.74	$681.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $153.13 / $2,513.09	Professional		$139.21	$153.13	$2,513.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.33 / $136.43 / $283.95	Facility		$131.33	$136.43	$283.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $170.73	Professional		$139.21	$139.21	$170.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $84.45 / $139.21 / $322.89	Facility		$84.45	$139.21	$322.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $139.21 / $275.14	Professional		$81.90	$139.21	$275.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $152.53 / $183.88	Professional		$75.00	$152.53	$183.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $138.66 / $157.60 / $332.45	Facility		$138.66	$157.60	$332.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.19 / $195.95 / $358.61	Facility		$114.19	$195.95	$358.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.15 / $173.75 / $314.02	Professional		$144.15	$173.75	$314.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $133.16 / $153.13 / $266.32	Facility		$133.16	$153.13	$266.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $153.13 / $167.05	Professional		$139.21	$153.13	$167.05
United Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $167.05	Professional		$139.21	$139.21	$167.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $136.43 / $139.21 / $139.21	Professional		$136.43	$139.21	$139.21