Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.34 / $182.37 / $190.41	Facility		$80.34	$182.37	$190.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.95 / $80.34 / $182.37	Professional		$64.95	$80.34	$182.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $60.42 / $321.02 / $620.42	Facility		$60.42	$321.02	$620.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $52.90 / $101.92 / $1,040.40	Professional		$52.90	$101.92	$1,040.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $133.72	Facility		$133.72	$133.72	$133.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $97.62 / $133.72	Professional		$97.62	$97.62	$133.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $59.12 / $208.39 / $395.57	Facility		$59.12	$208.39	$395.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.12 / $208.39 / $366.58	Professional		$59.12	$208.39	$366.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $178.40 / $198.23 / $218.05	Professional		$178.40	$198.23	$218.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.23 / $164.34 / $205.25	Facility		$62.23	$164.34	$205.25
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $92.75 / $199.94	Professional		$62.23	$92.75	$199.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.53 / $105.74 / $166.16	Facility		$75.53	$105.74	$166.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.36 / $51.36 / $51.36	Professional		$51.36	$51.36	$51.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $60.42 / $60.42 / $106.85	Facility		$60.42	$60.42	$106.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.26 / $53.52 / $205.42	Professional		$50.26	$53.52	$205.42
United Facility/Professional Professional Modifier Low / Median / High Price $90.31 / $97.84 / $162.80	Professional		$90.31	$97.84	$162.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $119.07 / $130.65 / $130.65	Professional		$119.07	$130.65	$130.65