Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.31 / $313.95 / $327.80	Facility		$138.31	$313.95	$327.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.19 / $138.31 / $239.28	Professional		$117.19	$138.31	$239.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $179.46 / $426.12 / $977.65	Facility		$179.46	$426.12	$977.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $145.91 / $179.34 / $1,056.91	Professional		$145.91	$179.34	$1,056.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.54 / $140.54 / $140.54	Facility		$140.54	$140.54	$140.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.59 / $102.59 / $140.54	Professional		$102.59	$102.59	$140.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.97 / $217.09 / $537.17	Facility		$117.97	$217.09	$537.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.32 / $216.41 / $398.02	Professional		$124.32	$216.41	$398.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $204.94 / $204.94	Professional		$60.00	$204.94	$204.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.66 / $200.14 / $212.23	Facility		$162.66	$200.14	$212.23
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $194.69 / $204.94 / $212.23	Professional		$194.69	$204.94	$212.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $179.46 / $230.16 / $400.28	Facility		$179.46	$230.16	$400.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $195.07 / $200.14 / $200.14	Facility		$195.07	$200.14	$200.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.80 / $174.20 / $225.43	Professional		$162.80	$174.20	$225.43
United Facility/Professional Professional Modifier Low / Median / High Price $86.51 / $93.72 / $178.52	Professional		$86.51	$93.72	$178.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.26 / $83.26 / $114.05	Professional		$83.26	$83.26	$114.05