Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.97 / $270.06 / $281.95	Facility		$118.97	$270.06	$281.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.75 / $118.97 / $281.95	Professional		$105.75	$118.97	$281.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $154.37 / $357.87 / $918.20	Facility		$154.37	$357.87	$918.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $166.89 / $1,170.59	Professional		$128.69	$166.89	$1,170.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.16 / $110.16 / $110.16	Facility		$110.16	$110.16	$110.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.42 / $80.42 / $110.16	Professional		$80.42	$80.42	$110.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $111.02 / $187.63 / $483.11	Facility		$111.02	$187.63	$483.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.14 / $189.01 / $374.03	Professional		$111.14	$189.01	$374.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $121.63 / $135.15 / $148.66	Professional		$121.63	$135.15	$148.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $139.94 / $172.16 / $235.06	Facility		$139.94	$172.16	$235.06
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $158.66 / $176.29 / $235.06	Professional		$158.66	$176.29	$235.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.37 / $197.98 / $344.32	Facility		$154.37	$197.98	$344.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $167.80 / $172.16 / $172.16	Facility		$167.80	$172.16	$172.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $140.05 / $149.85 / $193.92	Professional		$140.05	$149.85	$193.92
United Facility/Professional Professional Modifier Low / Median / High Price $81.31 / $87.95 / $167.80	Professional		$81.31	$87.95	$167.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.45 / $62.45 / $107.22	Professional		$62.45	$62.45	$107.22