Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.85 / $319.73 / $333.81	Facility		$140.85	$319.73	$333.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.95 / $140.85 / $333.81	Professional		$112.95	$140.85	$333.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $182.76 / $427.42 / $1,062.92	Facility		$182.76	$427.42	$1,062.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $156.00 / $196.97 / $1,247.71	Professional		$156.00	$196.97	$1,247.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.19 / $136.19 / $136.19	Facility		$136.19	$136.19	$136.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.43 / $99.43 / $136.19	Professional		$99.43	$99.43	$136.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $133.12 / $216.01 / $571.88	Facility		$133.12	$216.01	$571.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.91 / $221.10 / $427.81	Professional		$133.91	$221.10	$427.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $143.99 / $159.99 / $175.98	Professional		$143.99	$159.99	$175.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.66 / $201.70 / $208.72	Facility		$165.66	$201.70	$208.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $187.85 / $208.72 / $208.72	Professional		$187.85	$208.72	$208.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.76 / $234.40 / $407.66	Facility		$182.76	$234.40	$407.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $198.66 / $203.83 / $203.83	Facility		$198.66	$203.83	$203.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.79 / $177.41 / $229.59	Professional		$165.79	$177.41	$229.59
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $93.04 / $116.30 / $191.98	Professional		$93.04	$116.30	$191.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $119.69 / $119.69 / $122.85	Professional		$119.69	$119.69	$122.85