Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $666.79 / $749.28	Facility		$141.00	$666.79	$749.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.76 / $127.38 / $243.93	Professional		$107.76	$127.38	$243.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $182.95 / $441.99 / $969.09	Facility		$182.95	$441.99	$969.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $146.26 / $181.78 / $1,272.50	Professional		$146.26	$181.78	$1,272.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.33 / $138.33 / $203.46	Facility		$138.33	$138.33	$203.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $100.98 / $138.33	Professional		$100.98	$100.98	$138.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $121.48 / $208.94 / $552.17	Facility		$121.48	$208.94	$552.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.61 / $213.12 / $408.78	Professional		$121.61	$213.12	$408.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $144.14 / $160.16 / $176.17	Professional		$144.14	$160.16	$176.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.85 / $192.80 / $208.94	Facility		$165.85	$192.80	$208.94
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $165.97 / $192.80 / $208.94	Professional		$165.97	$192.80	$208.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.95 / $234.65 / $408.08	Facility		$182.95	$234.65	$408.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $198.87 / $204.04 / $204.04	Facility		$198.87	$204.04	$204.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.97 / $177.60 / $229.83	Professional		$165.97	$177.60	$229.83
United Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $96.34 / $183.51	Professional		$88.93	$96.34	$183.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $31.22 / $119.57	Professional		$31.22	$31.22	$119.57