Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.39 / $234.70 / $388.00	Facility		$103.39	$234.70	$388.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.88 / $103.39 / $245.03	Professional		$88.88	$103.39	$245.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $134.15 / $318.64 / $730.97	Facility		$134.15	$318.64	$730.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $109.10 / $134.07 / $790.38	Professional		$109.10	$134.07	$790.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.06 / $99.06 / $99.06	Facility		$99.06	$99.06	$99.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $72.31 / $99.06	Professional		$72.31	$72.31	$99.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $88.27 / $153.19 / $401.25	Facility		$88.27	$153.19	$401.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.36 / $155.13 / $297.89	Professional		$88.36	$155.13	$297.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.70 / $117.45 / $129.19	Professional		$105.70	$117.45	$129.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $121.61 / $149.61 / $158.71	Facility		$121.61	$149.61	$158.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $137.88 / $153.19 / $158.71	Professional		$137.88	$153.19	$158.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.15 / $172.05 / $299.22	Facility		$134.15	$172.05	$299.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $145.82 / $149.61 / $149.61	Facility		$145.82	$149.61	$149.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $121.71 / $130.22 / $168.52	Professional		$121.71	$130.22	$168.52
United Facility/Professional Professional Modifier Low / Median / High Price $64.69 / $70.08 / $133.47	Professional		$64.69	$70.08	$133.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $16.10 / $16.10 / $84.59	Professional		$16.10	$16.10	$84.59