Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.98 / $179.29 / $187.18	Facility		$78.98	$179.29	$187.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.54 / $78.98 / $187.18	Professional		$65.54	$78.98	$187.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $102.48 / $237.59 / $547.75	Facility		$102.48	$237.59	$547.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $81.92 / $101.82 / $582.86	Professional		$81.92	$101.82	$582.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.70 / $75.70 / $75.70	Facility		$75.70	$75.70	$75.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.27 / $55.27 / $75.70	Professional		$55.27	$55.27	$75.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $70.08 / $119.67 / $320.69	Facility		$70.08	$119.67	$320.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.09 / $121.69 / $223.42	Professional		$74.09	$121.69	$223.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.74 / $89.72 / $98.69	Professional		$80.74	$89.72	$98.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $105.34 / $114.30 / $128.74	Facility		$105.34	$114.30	$128.74
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $92.97 / $92.97 / $92.97	Professional		$92.97	$92.97	$92.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.48 / $131.44 / $228.60	Facility		$102.48	$131.44	$228.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.16 / $97.16 / $97.16	Professional		$97.16	$97.16	$97.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $111.40 / $114.30 / $114.30	Facility		$111.40	$114.30	$114.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $92.97 / $99.48 / $128.74	Professional		$92.97	$99.48	$128.74
United Facility/Professional Professional Modifier Low / Median / High Price $49.46 / $56.68 / $100.26	Professional		$49.46	$56.68	$100.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.03 / $63.03 / $63.03	Professional		$63.03	$63.03	$63.03