Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.97 / $238.28 / $248.78	Facility		$104.97	$238.28	$248.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.88 / $104.97 / $181.60	Professional		$78.88	$104.97	$181.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $136.19 / $323.52 / $742.11	Facility		$136.19	$323.52	$742.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $110.76 / $136.13 / $802.33	Professional		$110.76	$136.13	$802.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.96 / $88.96 / $88.96	Facility		$88.96	$88.96	$88.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.94 / $64.94 / $88.96	Professional		$64.94	$64.94	$88.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $89.73 / $164.77 / $407.81	Facility		$89.73	$164.77	$407.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.56 / $164.47 / $302.86	Professional		$94.56	$164.47	$302.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $155.55 / $155.55	Professional		$60.00	$155.55	$155.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.46 / $151.90 / $161.11	Facility		$123.46	$151.90	$161.11
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $132.22 / $155.55 / $161.11	Professional		$132.22	$155.55	$161.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.19 / $174.69 / $303.80	Facility		$136.19	$174.69	$303.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $148.05 / $151.90 / $151.90	Facility		$148.05	$151.90	$151.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $123.57 / $132.22 / $171.11	Professional		$123.57	$132.22	$171.11
United Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $71.02 / $135.50	Professional		$65.66	$71.02	$135.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $31.22 / $86.70	Professional		$31.22	$31.22	$86.70