Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.04 / $202.12 / $211.03	Facility		$89.04	$202.12	$211.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.06 / $89.04 / $154.04	Professional		$79.06	$89.04	$154.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $115.53 / $324.25 / $709.25	Facility		$115.53	$324.25	$709.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $96.32 / $130.30 / $888.80	Professional		$96.32	$130.30	$888.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.32 / $103.32 / $103.32	Facility		$103.32	$103.32	$103.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $75.42 / $103.32	Professional		$75.42	$75.42	$103.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $82.81 / $139.94 / $361.53	Facility		$82.81	$139.94	$361.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $82.90 / $140.91 / $279.69	Professional		$82.90	$140.91	$279.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.02 / $101.14 / $111.25	Professional		$91.02	$101.14	$111.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $128.84 / $171.81	Facility		$104.73	$128.84	$171.81
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $112.15 / $131.94 / $171.81	Professional		$112.15	$131.94	$171.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.53 / $148.16 / $257.68	Facility		$115.53	$148.16	$257.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.58 / $128.84 / $128.84	Facility		$125.58	$128.84	$128.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.81 / $112.15 / $145.13	Professional		$104.81	$112.15	$145.13
United Facility/Professional Professional Modifier Low / Median / High Price $60.86 / $65.81 / $125.58	Professional		$60.86	$65.81	$125.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $46.84 / $79.04	Professional		$46.84	$46.84	$79.04