Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.17 / $288.68 / $301.39	Facility		$127.17	$288.68	$301.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.32 / $127.17 / $301.39	Professional		$109.32	$127.17	$301.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $165.01 / $391.95 / $899.12	Facility		$165.01	$391.95	$899.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $134.19 / $164.92 / $972.15	Professional		$134.19	$164.92	$972.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.78 / $107.78 / $107.78	Facility		$107.78	$107.78	$107.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $78.68 / $107.78	Professional		$78.68	$78.68	$107.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.28 / $188.45 / $493.12	Facility		$74.28	$188.45	$493.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.28 / $188.45 / $365.75	Professional		$74.28	$188.45	$365.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $159.83 / $177.59 / $200.03	Professional		$159.83	$177.59	$200.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $149.59 / $184.03 / $195.21	Facility		$149.59	$184.03	$195.21
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $179.03 / $188.45 / $195.21	Professional		$179.03	$188.45	$195.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.01 / $211.63 / $368.06	Facility		$165.01	$211.63	$368.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $179.37 / $184.03 / $184.03	Facility		$179.37	$184.03	$184.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $149.71 / $160.18 / $207.30	Professional		$149.71	$160.18	$207.30
United Facility/Professional Facility Modifier Low / Median / High Price $66.30 / $85.28 / $110.18	Facility		$66.30	$85.28	$110.18
United Facility/Professional Professional Modifier Low / Median / High Price $79.56 / $86.19 / $164.17	Professional		$79.56	$86.19	$164.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.34 / $21.34 / $160.18	Professional		$21.34	$21.34	$160.18