Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.58 / $176.11 / $183.87	Facility		$77.58	$176.11	$183.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.53 / $77.58 / $183.87	Professional		$54.53	$77.58	$183.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.66 / $263.58 / $528.70	Facility		$100.66	$263.58	$528.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $80.47 / $97.71 / $743.76	Professional		$80.47	$97.71	$743.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.99 / $83.99 / $83.99	Facility		$83.99	$83.99	$83.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.31 / $61.31 / $83.99	Professional		$61.31	$61.31	$83.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $61.42 / $114.95 / $278.43	Facility		$61.42	$114.95	$278.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.49 / $112.02 / $206.87	Professional		$61.49	$112.02	$206.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.31 / $88.13 / $96.94	Professional		$79.31	$88.13	$96.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.25 / $103.46 / $114.95	Facility		$91.25	$103.46	$114.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $97.38 / $114.95 / $114.95	Professional		$97.38	$114.95	$114.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.66 / $129.10 / $224.52	Facility		$100.66	$129.10	$224.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.42 / $95.42 / $95.42	Professional		$95.42	$95.42	$95.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $109.42 / $112.26 / $112.26	Facility		$109.42	$112.26	$112.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.33 / $97.71 / $126.45	Professional		$91.33	$97.71	$126.45
United Facility/Professional Professional Modifier Low / Median / High Price $45.73 / $52.40 / $92.69	Professional		$45.73	$52.40	$92.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $59.66 / $64.02 / $64.02	Professional		$59.66	$64.02	$64.02