Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.57 / $157.84 / $283.36	Facility		$134.57	$157.84	$283.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $138.03 / $170.83	Professional		$136.66	$138.03	$170.83
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $124.72 / $194.94 / $663.65	Facility		$124.72	$194.94	$663.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $150.34 / $586.87	Professional		$136.66	$150.34	$586.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.93 / $132.91 / $265.45	Facility		$128.93	$132.91	$265.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $167.61	Professional		$136.66	$136.66	$167.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $118.11 / $168.69 / $326.69	Facility		$118.11	$168.69	$326.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.78 / $166.95 / $303.69	Professional		$124.78	$166.95	$303.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $146.00 / $179.18	Professional		$75.00	$146.00	$179.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $154.72 / $408.69	Facility		$136.22	$154.72	$408.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.86 / $190.16 / $348.01	Facility		$111.86	$190.16	$348.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.44 / $169.28 / $305.95	Professional		$140.44	$169.28	$305.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $129.96 / $151.56 / $282.32	Facility		$129.96	$151.56	$282.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $150.34 / $164.00	Professional		$136.66	$150.34	$164.00
United Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $164.00	Professional		$136.66	$136.66	$164.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $132.91 / $136.66 / $136.66	Professional		$132.91	$136.66	$136.66