Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.25 / $257.08 / $268.39	Facility		$113.25	$257.08	$268.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.66 / $113.25 / $268.39	Professional		$100.66	$113.25	$268.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $92.76 / $277.89 / $943.35	Facility		$92.76	$277.89	$943.35
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $143.38 / $671.73	Professional		$81.20	$143.38	$671.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.82 / $211.82 / $211.82	Facility		$211.82	$211.82	$211.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.63 / $154.63 / $211.82	Professional		$154.63	$154.63	$211.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $90.76 / $366.87 / $963.34	Facility		$90.76	$366.87	$963.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $353.29 / $615.46	Professional		$90.76	$353.29	$615.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $232.65 / $258.51 / $284.36	Professional		$232.65	$258.51	$284.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.54 / $142.38 / $277.07	Facility		$95.54	$142.38	$277.07
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $142.38 / $142.38 / $142.38	Professional		$142.38	$142.38	$142.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.84 / $143.38 / $185.52	Facility		$78.84	$143.38	$185.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $142.33 / $277.17	Professional		$78.84	$142.33	$277.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $92.76 / $92.76 / $149.82	Facility		$92.76	$92.76	$149.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.15 / $82.16 / $267.89	Professional		$77.15	$82.16	$267.89
United Facility/Professional Professional Modifier Low / Median / High Price $144.97 / $154.02 / $256.70	Professional		$144.97	$154.02	$256.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $193.20 / $193.20 / $193.20	Professional		$193.20	$193.20	$193.20