Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.33 / $311.74 / $325.47	Facility		$137.33	$311.74	$325.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.33 / $137.33 / $325.47	Professional		$100.33	$137.33	$325.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $178.19 / $464.48 / $949.34	Facility		$178.19	$464.48	$949.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $142.28 / $175.01 / $1,146.61	Professional		$142.28	$175.01	$1,146.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $111.95 / $111.95	Facility		$111.95	$111.95	$111.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $81.72 / $123.90	Professional		$81.72	$81.72	$123.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $112.84 / $203.50 / $512.80	Facility		$112.84	$203.50	$512.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.96 / $203.50 / $380.65	Professional		$112.96	$203.50	$380.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $140.40 / $156.00 / $171.60	Professional		$140.40	$156.00	$171.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $161.53 / $183.15 / $203.50	Facility		$161.53	$183.15	$203.50
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $172.98 / $197.08 / $203.50	Professional		$172.98	$197.08	$203.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $178.19 / $228.54 / $397.46	Facility		$178.19	$228.54	$397.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $193.69 / $198.73 / $198.73	Facility		$193.69	$198.73	$198.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $161.66 / $172.98 / $223.85	Professional		$161.66	$172.98	$223.85
United Facility/Professional Professional Modifier Low / Median / High Price $82.64 / $103.30 / $170.53	Professional		$82.64	$103.30	$170.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $78.06 / $109.12	Professional		$78.06	$78.06	$109.12