Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.76 / $258.24 / $269.61	Facility		$113.76	$258.24	$269.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.79 / $113.76 / $269.61	Professional		$97.79	$113.76	$269.61
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $147.60 / $350.62 / $804.26	Facility		$147.60	$350.62	$804.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $120.04 / $147.51 / $869.66	Professional		$120.04	$147.51	$869.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.46 / $116.46 / $116.46	Facility		$116.46	$116.46	$116.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.02 / $85.02 / $116.46	Professional		$85.02	$85.02	$116.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $96.91 / $168.56 / $441.56	Facility		$96.91	$168.56	$441.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $170.33 / $326.86	Professional		$97.02	$170.33	$326.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.30 / $129.22 / $142.15	Professional		$116.30	$129.22	$142.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $133.80 / $164.61 / $174.63	Facility		$133.80	$164.61	$174.63
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $151.69 / $168.56 / $174.63	Professional		$151.69	$168.56	$174.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.60 / $189.30 / $329.22	Facility		$147.60	$189.30	$329.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $160.44 / $164.61 / $164.61	Facility		$160.44	$164.61	$164.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $133.91 / $143.28 / $185.42	Professional		$133.91	$143.28	$185.42
United Facility/Professional Professional Modifier Low / Median / High Price $71.17 / $83.03 / $146.85	Professional		$71.17	$83.03	$146.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.56 / $62.56 / $92.09	Professional		$62.56	$62.56	$92.09