Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.45 / $175.81 / $183.56	Facility		$77.45	$175.81	$183.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.77 / $77.45 / $183.56	Professional		$56.77	$77.45	$183.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.50 / $274.39 / $540.12	Facility		$100.50	$274.39	$540.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $80.80 / $99.35 / $648.82	Professional		$80.80	$99.35	$648.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.42 / $87.42 / $87.42	Facility		$87.42	$87.42	$87.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $63.82 / $87.42	Professional		$63.82	$63.82	$87.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $63.70 / $114.77 / $290.62	Facility		$63.70	$114.77	$290.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.77 / $114.77 / $215.15	Professional		$63.77	$114.77	$215.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.17 / $87.97 / $96.76	Professional		$79.17	$87.97	$96.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.08 / $103.29 / $114.77	Facility		$91.08	$103.29	$114.77
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $101.38 / $114.77 / $114.77	Professional		$101.38	$114.77	$114.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.50 / $128.88 / $224.16	Facility		$100.50	$128.88	$224.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $95.27 / $95.27	Professional		$95.27	$95.27	$95.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $109.24 / $112.08 / $112.08	Facility		$109.24	$112.08	$112.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $97.55 / $126.25	Professional		$91.16	$97.55	$126.25
United Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $50.65 / $96.49	Professional		$46.76	$50.65	$96.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $36.43 / $62.47	Professional		$36.43	$36.43	$62.47