Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.36 / $291.48 / $309.04	Facility		$73.36	$291.48	$309.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.78 / $73.36 / $166.53	Professional		$52.78	$73.36	$166.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $95.19 / $216.84 / $471.51	Facility		$95.19	$216.84	$471.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $70.92 / $92.40 / $668.93	Professional		$70.92	$92.40	$668.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.78 / $66.78 / $66.78	Facility		$66.78	$66.78	$66.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $48.75 / $66.78	Professional		$48.75	$48.75	$66.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $55.51 / $105.56 / $251.25	Facility		$55.51	$105.56	$251.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $104.09 / $187.01	Professional		$55.57	$104.09	$187.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.01 / $83.35 / $91.68	Professional		$75.01	$83.35	$91.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $85.83 / $96.68 / $108.71	Facility		$85.83	$96.68	$108.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $87.89 / $108.71 / $108.71	Professional		$87.89	$108.71	$108.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.19 / $122.08 / $212.32	Facility		$95.19	$122.08	$212.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.24 / $90.24 / $90.24	Professional		$90.24	$90.24	$90.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $103.47 / $106.16 / $106.16	Facility		$103.47	$106.16	$106.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $86.37 / $92.40 / $119.58	Professional		$86.37	$92.40	$119.58
United Facility/Professional Facility Modifier Low / Median / High Price $117.18 / $140.62 / $140.62	Facility		$117.18	$140.62	$140.62
United Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $43.85 / $83.65	Professional		$40.54	$43.85	$83.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $72.86 / $72.86	Professional		$52.58	$72.86	$72.86