Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.07 / $206.73 / $215.84	Facility		$91.07	$206.73	$215.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.81 / $91.07 / $215.84	Professional		$63.81	$91.07	$215.84
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $118.16 / $256.97 / $593.85	Facility		$118.16	$256.97	$593.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $114.70 / $667.95	Professional		$80.90	$114.70	$667.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $84.33 / $84.33	Facility		$84.33	$84.33	$84.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $61.56 / $84.33	Professional		$61.56	$61.56	$84.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $71.89 / $134.94 / $326.25	Facility		$71.89	$134.94	$326.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.95 / $131.37 / $241.63	Professional		$71.95	$131.37	$241.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $103.46 / $113.80	Professional		$93.11	$103.46	$113.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.13 / $121.45 / $134.94	Facility		$107.13	$121.45	$134.94
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $107.21 / $128.19 / $134.94	Professional		$107.21	$128.19	$134.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.16 / $151.55 / $263.56	Facility		$118.16	$151.55	$263.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.44 / $131.78 / $131.78	Facility		$128.44	$131.78	$131.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.21 / $114.70 / $148.43	Professional		$107.21	$114.70	$148.43
United Facility/Professional Professional Modifier Low / Median / High Price $52.56 / $59.71 / $108.46	Professional		$52.56	$59.71	$108.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.37 / $49.37 / $114.70	Professional		$49.37	$49.37	$114.70