Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.25 / $232.11 / $242.33	Facility		$102.25	$232.11	$242.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.85 / $102.25 / $242.33	Professional		$84.85	$102.25	$242.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $132.66 / $379.63 / $797.99	Facility		$132.66	$379.63	$797.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $109.61 / $132.66 / $821.86	Professional		$109.61	$132.66	$821.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.63 / $132.63 / $132.63	Facility		$132.63	$132.63	$132.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.83 / $96.83 / $132.63	Professional		$96.83	$96.83	$132.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.55 / $161.49 / $415.15	Facility		$95.55	$161.49	$415.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.65 / $162.00 / $321.07	Professional		$95.65	$162.00	$321.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.53 / $116.15 / $127.76	Professional		$104.53	$116.15	$127.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.26 / $147.96 / $151.51	Facility		$120.26	$147.96	$151.51
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $151.51 / $151.51	Professional		$120.36	$151.51	$151.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.66 / $170.15 / $295.92	Facility		$132.66	$170.15	$295.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $144.21 / $147.96 / $147.96	Facility		$144.21	$147.96	$147.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $128.78 / $166.66	Professional		$120.36	$128.78	$166.66
United Facility/Professional Professional Modifier Low / Median / High Price $69.89 / $81.54 / $144.21	Professional		$69.89	$81.54	$144.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.53 / $64.53 / $92.70	Professional		$64.53	$64.53	$92.70