Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.96 / $211.02 / $220.32	Facility		$92.96	$211.02	$220.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $92.96 / $220.32	Professional		$73.81	$92.96	$220.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $274.86 / $634.55	Facility		$120.62	$274.86	$634.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $93.40 / $119.84 / $868.91	Professional		$93.40	$119.84	$868.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.09 / $75.09 / $75.09	Facility		$75.09	$75.09	$75.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.82 / $54.82 / $76.81	Professional		$54.82	$54.82	$76.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $75.53 / $137.75 / $344.06	Facility		$75.53	$137.75	$344.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.61 / $137.75 / $254.87	Professional		$75.61	$137.75	$254.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.04 / $105.61 / $116.17	Professional		$95.04	$105.61	$116.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.35 / $131.80 / $137.75	Facility		$109.35	$131.80	$137.75
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $109.35 / $131.80 / $137.75	Professional		$109.35	$131.80	$137.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $154.69 / $269.04	Facility		$120.62	$154.69	$269.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.11 / $134.52 / $134.52	Facility		$131.11	$134.52	$134.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $117.09 / $151.53	Professional		$109.44	$117.09	$151.53
United Facility/Professional Professional Modifier Low / Median / High Price $55.43 / $60.53 / $114.38	Professional		$55.43	$60.53	$114.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.57 / $52.57 / $72.28	Professional		$52.57	$52.57	$72.28