Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.66 / $339.73 / $354.69	Facility		$149.66	$339.73	$354.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.93 / $149.66 / $258.91	Professional		$102.93	$149.66	$258.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $194.18 / $422.29 / $1,009.99	Facility		$194.18	$422.29	$1,009.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $142.00 / $188.50 / $1,176.33	Professional		$142.00	$188.50	$1,176.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.23 / $126.23 / $126.23	Facility		$126.23	$126.23	$126.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.15 / $92.15 / $126.23	Professional		$92.15	$92.15	$126.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $121.16 / $220.68 / $574.29	Facility		$121.16	$220.68	$574.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.92 / $220.68 / $389.75	Professional		$121.92	$220.68	$389.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $170.00 / $187.00	Professional		$153.00	$170.00	$187.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $176.04 / $199.58 / $221.76	Facility		$176.04	$199.58	$221.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $183.80 / $221.76 / $221.76	Professional		$183.80	$221.76	$221.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.18 / $249.04 / $433.12	Facility		$194.18	$249.04	$433.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $211.07 / $216.56 / $216.56	Facility		$211.07	$216.56	$216.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $176.17 / $188.50 / $243.94	Professional		$176.17	$188.50	$243.94
United Facility/Professional Professional Modifier Low / Median / High Price $84.78 / $95.69 / $174.95	Professional		$84.78	$95.69	$174.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.04 / $52.04 / $111.78	Professional		$52.04	$52.04	$111.78