Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.41 / $196.15 / $204.79	Facility		$86.41	$196.15	$204.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $86.41 / $149.49	Professional		$63.39	$86.41	$149.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $112.12 / $261.79 / $645.14	Facility		$112.12	$261.79	$645.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $92.51 / $118.89 / $779.14	Professional		$92.51	$118.89	$779.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $77.09 / $100.50	Facility		$77.09	$77.09	$100.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $56.28 / $100.50	Professional		$56.28	$56.28	$100.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $80.59 / $130.78 / $348.75	Facility		$80.59	$130.78	$348.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.64 / $134.34 / $258.18	Professional		$80.64	$134.34	$258.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.35 / $98.17 / $107.98	Professional		$88.35	$98.17	$107.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $101.65 / $121.74 / $128.04	Facility		$101.65	$121.74	$128.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $115.24 / $121.74 / $128.04	Professional		$115.24	$121.74	$128.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.12 / $143.80 / $250.08	Facility		$112.12	$143.80	$250.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $121.87 / $125.04 / $125.04	Facility		$121.87	$125.04	$125.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $101.73 / $108.83 / $140.84	Professional		$101.73	$108.83	$140.84
United Facility/Professional Professional Modifier Low / Median / High Price $56.15 / $60.83 / $115.88	Professional		$56.15	$60.83	$115.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.24 / $57.24 / $74.05	Professional		$57.24	$57.24	$74.05