Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.29 / $216.31 / $225.84	Facility		$95.29	$216.31	$225.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.70 / $95.29 / $225.84	Professional		$84.70	$95.29	$225.84
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $123.64 / $315.64 / $735.04	Facility		$123.64	$315.64	$735.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $103.08 / $138.69 / $980.55	Professional		$103.08	$138.69	$980.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.66 / $86.66 / $86.66	Facility		$86.66	$86.66	$86.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $63.26 / $86.66	Professional		$63.26	$63.26	$86.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $87.36 / $148.50 / $386.94	Facility		$87.36	$148.50	$386.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.45 / $148.50 / $293.76	Professional		$87.45	$148.50	$293.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.41 / $108.24 / $119.06	Professional		$97.41	$108.24	$119.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $112.08 / $137.88 / $184.93	Facility		$112.08	$137.88	$184.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $112.17 / $141.19 / $184.93	Professional		$112.17	$141.19	$184.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.64 / $158.57 / $275.77	Facility		$123.64	$158.57	$275.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $134.40 / $137.88 / $137.88	Facility		$134.40	$137.88	$137.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.17 / $120.02 / $155.32	Professional		$112.17	$120.02	$155.32
United Facility/Professional Professional Modifier Low / Median / High Price $63.97 / $69.30 / $132.01	Professional		$63.97	$69.30	$132.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $46.84 / $81.20	Professional		$46.84	$46.84	$81.20