Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.39 / $218.81 / $228.44	Facility		$96.39	$218.81	$228.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.89 / $96.39 / $228.44	Professional		$82.89	$96.39	$228.44
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $125.07 / $297.13 / $681.55	Facility		$125.07	$297.13	$681.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $101.73 / $124.99 / $737.14	Professional		$101.73	$124.99	$737.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $81.70 / $81.70	Facility		$81.70	$81.70	$81.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $59.64 / $81.70	Professional		$59.64	$59.64	$81.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $82.35 / $142.83 / $375.00	Facility		$82.35	$142.83	$375.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $82.44 / $144.74 / $278.04	Professional		$82.44	$144.74	$278.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.54 / $109.49 / $120.43	Professional		$98.54	$109.49	$120.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $113.36 / $139.47 / $148.02	Facility		$113.36	$139.47	$148.02
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $128.55 / $142.83 / $148.02	Professional		$128.55	$142.83	$148.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.07 / $160.40 / $278.95	Facility		$125.07	$160.40	$278.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $135.94 / $139.47 / $139.47	Facility		$135.94	$139.47	$139.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $113.46 / $121.41 / $157.11	Professional		$113.46	$121.41	$157.11
United Facility/Professional Professional Modifier Low / Median / High Price $60.31 / $65.33 / $124.45	Professional		$60.31	$65.33	$124.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.13 / $152.47 / $152.47	Professional		$79.13	$152.47	$152.47