Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $188.93 / $197.26	Facility		$83.23	$188.93	$197.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.98 / $83.23 / $188.93	Professional		$73.98	$83.23	$188.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $107.99 / $290.51 / $647.48	Facility		$107.99	$290.51	$647.48
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $90.02 / $120.85 / $918.41	Professional		$90.02	$120.85	$918.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.77 / $79.77 / $79.77	Facility		$79.77	$79.77	$79.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $58.23 / $79.77	Professional		$58.23	$58.23	$79.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $77.80 / $131.49 / $337.95	Facility		$77.80	$131.49	$337.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.89 / $132.47 / $261.49	Professional		$77.89	$132.47	$261.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.08 / $94.54 / $103.99	Professional		$85.08	$94.54	$103.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.89 / $120.43 / $164.43	Facility		$97.89	$120.43	$164.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $110.99 / $123.32 / $164.43	Professional		$110.99	$123.32	$164.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.99 / $138.49 / $240.86	Facility		$107.99	$138.49	$240.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $117.38 / $120.43 / $120.43	Facility		$117.38	$120.43	$120.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $97.97 / $104.82 / $135.65	Professional		$97.97	$104.82	$135.65
United Facility/Professional Professional Modifier Low / Median / High Price $56.89 / $61.63 / $117.38	Professional		$56.89	$61.63	$117.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.28 / $45.28 / $74.53	Professional		$45.28	$45.28	$74.53