Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.79 / $324.13 / $338.41	Facility		$142.79	$324.13	$338.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.18 / $142.79 / $338.41	Professional		$118.18	$142.79	$338.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $185.28 / $423.74 / $981.02	Facility		$185.28	$423.74	$981.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $142.59 / $184.09 / $1,050.93	Professional		$142.59	$184.09	$1,050.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.05 / $147.05 / $147.05	Facility		$147.05	$147.05	$147.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.35 / $107.35 / $147.05	Professional		$107.35	$107.35	$147.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.84 / $211.60 / $537.17	Facility		$117.84	$211.60	$537.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.97 / $211.60 / $398.02	Professional		$117.97	$211.60	$398.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $145.99 / $162.22 / $178.44	Professional		$145.99	$162.22	$178.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $167.98 / $206.64 / $211.60	Facility		$167.98	$206.64	$211.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $190.44 / $211.60 / $215.83	Professional		$190.44	$211.60	$215.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $185.28 / $237.64 / $413.28	Facility		$185.28	$237.64	$413.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $201.40 / $206.64 / $206.64	Facility		$201.40	$206.64	$206.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $168.10 / $179.86 / $232.76	Professional		$168.10	$179.86	$232.76
United Facility/Professional Professional Modifier Low / Median / High Price $86.54 / $100.97 / $178.59	Professional		$86.54	$100.97	$178.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.28 / $114.28 / $114.28	Professional		$114.28	$114.28	$114.28