Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.49 / $211.50 / $2,259.61	Facility		$105.49	$211.50	$2,259.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $100.70 / $202.69	Professional		$95.90	$100.70	$202.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $154.19 / $243.87 / $2,009.53	Facility		$154.19	$243.87	$2,009.53
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $109.71 / $5,879.42	Professional		$95.90	$109.71	$5,879.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.47 / $95.90 / $324.20	Facility		$90.47	$95.90	$324.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $95.90 / $160.43	Professional		$95.90	$95.90	$160.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $552.44 / $2,014.58	Facility		$95.90	$552.44	$2,014.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $699.63 / $1,759.59	Professional		$95.90	$699.63	$1,759.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $118.83 / $172.81	Professional		$75.00	$118.83	$172.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $119.88 / $324.08	Facility		$95.90	$119.88	$324.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.22 / $245.71 / $414.46	Facility		$133.22	$245.71	$414.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.83 / $180.37 / $307.76	Professional		$148.83	$180.37	$307.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $154.19 / $194.16 / $497.06	Facility		$154.19	$194.16	$497.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $105.49 / $115.08	Professional		$95.90	$105.49	$115.08
United Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $101.65 / $158.24	Professional		$95.90	$101.65	$158.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $95.90 / $133.69	Professional		$95.90	$95.90	$133.69