Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.67 / $194.47 / $336.84	Facility		$85.67	$194.47	$336.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.33 / $85.67 / $203.04	Professional		$60.33	$85.67	$203.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $264.89 / $563.66	Facility		$111.15	$264.89	$563.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $83.64 / $108.61 / $689.52	Professional		$83.64	$108.61	$689.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.80 / $75.80 / $75.80	Facility		$75.80	$75.80	$75.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $55.33 / $75.80	Professional		$55.33	$55.33	$75.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $67.79 / $126.94 / $309.37	Facility		$67.79	$126.94	$309.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.86 / $124.24 / $228.39	Professional		$67.86	$124.24	$228.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.58 / $97.32 / $107.05	Professional		$87.58	$97.32	$107.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.78 / $114.25 / $126.94	Facility		$100.78	$114.25	$126.94
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $114.25 / $126.94	Professional		$100.78	$114.25	$126.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $142.55 / $247.92	Facility		$111.15	$142.55	$247.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $120.82 / $123.96 / $123.96	Facility		$120.82	$123.96	$123.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.85 / $107.90 / $139.63	Professional		$100.85	$107.90	$139.63
United Facility/Professional Facility Modifier Low / Median / High Price $71.80 / $71.80 / $71.80	Facility		$71.80	$71.80	$71.80
United Facility/Professional Professional Modifier Low / Median / High Price $49.70 / $57.98 / $102.55	Professional		$49.70	$57.98	$102.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.92 / $48.92 / $64.34	Professional		$48.92	$48.92	$64.34