Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.03 / $123.81 / $175.82	Facility		$93.03	$123.81	$175.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $86.26 / $104.54	Professional		$84.57	$86.26	$104.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $101.58 / $170.61 / $588.15	Facility		$101.58	$170.61	$588.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $93.03 / $518.54	Professional		$84.57	$93.03	$518.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.78 / $84.57 / $117.45	Facility		$79.78	$84.57	$117.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $103.72	Professional		$84.57	$84.57	$103.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $85.42 / $344.92	Facility		$84.57	$85.42	$344.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $165.76	Professional		$84.57	$84.57	$165.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $93.02 / $129.39	Professional		$75.00	$93.02	$129.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $84.53 / $84.57 / $175.44	Facility		$84.53	$84.57	$175.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.24 / $167.23 / $306.01	Facility		$85.24	$167.23	$306.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.45 / $149.58 / $270.35	Professional		$117.45	$149.58	$270.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $101.58 / $134.51 / $252.93	Facility		$101.58	$134.51	$252.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $93.03 / $101.49	Professional		$84.57	$93.03	$101.49
United Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $101.48	Professional		$84.57	$84.57	$101.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $117.45	Professional		$84.57	$84.57	$117.45