Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.32 / $560.70 / $594.38	Facility		$107.32	$560.70	$594.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.53 / $107.32 / $185.66	Professional		$84.53	$107.32	$185.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $139.25 / $384.30 / $791.34	Facility		$139.25	$384.30	$791.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $114.90 / $143.31 / $898.37	Professional		$114.90	$143.31	$898.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.36 / $117.36 / $126.78	Facility		$117.36	$117.36	$126.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.67 / $85.67 / $126.78	Professional		$85.67	$85.67	$126.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.09 / $162.00 / $432.18	Facility		$95.09	$162.00	$432.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.19 / $162.21 / $320.24	Professional		$95.19	$162.21	$320.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.72 / $121.92 / $134.11	Professional		$109.72	$121.92	$134.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $126.24 / $150.94 / $159.03	Facility		$126.24	$150.94	$159.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $143.13 / $159.03 / $174.93	Professional		$143.13	$159.03	$174.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.25 / $178.60 / $310.60	Facility		$139.25	$178.60	$310.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $155.30 / $155.30	Facility		$151.36	$155.30	$155.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $126.34 / $135.18 / $174.93	Professional		$126.34	$135.18	$174.93
United Facility/Professional Professional Modifier Low / Median / High Price $69.62 / $75.43 / $143.66	Professional		$69.62	$75.43	$143.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $46.84 / $94.06	Professional		$46.84	$46.84	$94.06