Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.54 / $203.26 / $212.21	Facility		$89.54	$203.26	$212.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.30 / $89.54 / $212.21	Professional		$74.30	$89.54	$212.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $116.18 / $448.96 / $729.99	Facility		$116.18	$448.96	$729.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $96.86 / $118.41 / $1,419.30	Professional		$96.86	$118.41	$1,419.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $106.22 / $106.22	Facility		$106.22	$106.22	$106.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.54 / $77.54 / $106.22	Professional		$77.54	$77.54	$106.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.26 / $140.72 / $363.58	Facility		$83.26	$140.72	$363.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.35 / $141.75 / $281.35	Professional		$83.35	$141.75	$281.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.53 / $101.71 / $111.88	Professional		$91.53	$101.71	$111.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $105.31 / $129.57 / $132.68	Facility		$105.31	$129.57	$132.68
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $119.41 / $132.68 / $132.68	Professional		$119.41	$132.68	$132.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.18 / $149.01 / $259.14	Facility		$116.18	$149.01	$259.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $126.28 / $129.57 / $129.57	Facility		$126.28	$129.57	$129.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $105.40 / $112.78 / $145.94	Professional		$105.40	$112.78	$145.94
United Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $65.59 / $84.75	Facility		$51.00	$65.59	$84.75
United Facility/Professional Professional Modifier Low / Median / High Price $61.20 / $71.40 / $126.28	Professional		$61.20	$71.40	$126.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.82 / $20.82 / $79.14	Professional		$20.82	$20.82	$79.14