Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.89 / $197.24 / $205.93	Facility		$86.89	$197.24	$205.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.23 / $86.89 / $205.93	Professional		$77.23	$86.89	$205.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $112.75 / $282.27 / $675.46	Facility		$112.75	$282.27	$675.46
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $93.99 / $126.18 / $892.26	Professional		$93.99	$126.18	$892.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.45 / $80.45 / $80.45	Facility		$80.45	$80.45	$80.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.73 / $58.73 / $81.50	Professional		$58.73	$58.73	$81.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $84.76 / $137.53 / $352.85	Facility		$84.76	$137.53	$352.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.44 / $138.24 / $273.07	Professional		$85.44	$138.24	$273.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $98.71 / $108.58	Professional		$88.83	$98.71	$108.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.21 / $125.74 / $171.68	Facility		$102.21	$125.74	$171.68
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $115.88 / $128.76 / $171.68	Professional		$115.88	$128.76	$171.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.75 / $144.60 / $251.48	Facility		$112.75	$144.60	$251.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $122.56 / $125.74 / $125.74	Facility		$122.56	$125.74	$125.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.29 / $109.45 / $141.63	Professional		$102.29	$109.45	$141.63
United Facility/Professional Professional Modifier Low / Median / High Price $59.39 / $69.29 / $122.56	Professional		$59.39	$69.29	$122.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.65 / $54.65 / $78.30	Professional		$54.65	$54.65	$78.30