Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.00 / $354.12 / $369.72	Facility		$156.00	$354.12	$369.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.44 / $156.00 / $354.12	Professional		$121.44	$156.00	$354.12
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $202.41 / $882.96 / $1,155.77	Facility		$202.41	$882.96	$1,155.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $162.65 / $202.41 / $2,791.49	Professional		$162.65	$202.41	$2,791.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.51 / $135.51 / $135.51	Facility		$135.51	$135.51	$135.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.92 / $98.92 / $143.51	Professional		$98.92	$98.92	$143.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $143.00 / $235.78 / $621.55	Facility		$143.00	$235.78	$621.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $239.91 / $460.09	Professional		$144.00	$239.91	$460.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $159.48 / $177.21 / $194.93	Professional		$159.48	$177.21	$194.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $183.50 / $216.86 / $231.16	Facility		$183.50	$216.86	$231.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $208.04 / $231.16 / $235.78	Professional		$208.04	$231.16	$235.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $202.41 / $259.60 / $451.48	Facility		$202.41	$259.60	$451.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $220.02 / $225.74 / $225.74	Facility		$220.02	$225.74	$225.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $183.64 / $196.49 / $254.28	Professional		$183.64	$196.49	$254.28
United Facility/Professional Professional Modifier Low / Median / High Price $100.03 / $108.19 / $206.41	Professional		$100.03	$108.19	$206.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.86 / $72.86 / $132.15	Professional		$72.86	$72.86	$132.15