Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.15 / $315.87 / $329.79	Facility		$139.15	$315.87	$329.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.16 / $139.15 / $240.73	Professional		$113.16	$139.15	$240.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $180.55 / $384.10 / $1,045.23	Facility		$180.55	$384.10	$1,045.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $156.69 / $186.45 / $1,231.68	Professional		$156.69	$186.45	$1,231.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.06 / $125.61 / $125.61	Facility		$80.06	$125.61	$125.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.70 / $91.70 / $184.63	Professional		$91.70	$91.70	$184.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $133.44 / $227.87 / $575.62	Facility		$133.44	$227.87	$575.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.05 / $231.68 / $426.99	Professional		$141.05	$231.68	$426.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $142.27 / $158.08 / $173.88	Professional		$142.27	$158.08	$173.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $163.68 / $201.36 / $212.89	Facility		$163.68	$201.36	$212.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $175.26 / $206.19 / $212.89	Professional		$175.26	$206.19	$212.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $171.16 / $180.55 / $392.65	Facility		$171.16	$180.55	$392.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.16 / $186.45 / $250.05	Professional		$171.16	$186.45	$250.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $196.26 / $201.36 / $201.36	Facility		$196.26	$201.36	$201.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $163.81 / $175.26 / $226.81	Professional		$163.81	$175.26	$226.81
United Facility/Professional Professional Modifier Low / Median / High Price $93.52 / $108.18 / $191.34	Professional		$93.52	$108.18	$191.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $175.26	Professional		$137.93	$137.93	$175.26