Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.97 / $208.77 / $217.97	Facility		$91.97	$208.77	$217.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.50 / $91.97 / $312.00	Professional		$77.50	$91.97	$312.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $119.33 / $317.83 / $717.68	Facility		$119.33	$317.83	$717.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $99.48 / $120.18 / $810.66	Professional		$99.48	$120.18	$810.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.16 / $85.16 / $85.16	Facility		$85.16	$85.16	$85.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.17 / $62.17 / $199.45	Professional		$62.17	$62.17	$199.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.54 / $144.57 / $373.43	Facility		$85.54	$144.57	$373.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.63 / $145.97 / $289.62	Professional		$85.63	$145.97	$289.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.02 / $104.47 / $114.91	Professional		$94.02	$104.47	$114.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $108.18 / $133.09 / $136.28	Facility		$108.18	$133.09	$136.28
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $136.28 / $149.91	Professional		$129.47	$136.28	$149.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $119.33 / $153.05 / $266.18	Facility		$119.33	$153.05	$266.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $129.71 / $133.09 / $133.09	Facility		$129.71	$133.09	$133.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $108.26 / $115.84 / $149.91	Professional		$108.26	$115.84	$149.91
United Facility/Professional Professional Modifier Low / Median / High Price $62.86 / $67.98 / $129.71	Professional		$62.86	$67.98	$129.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $84.87 / $84.87 / $115.84	Professional		$84.87	$84.87	$115.84