Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.47 / $207.64 / $216.78	Facility		$91.47	$207.64	$216.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $91.47 / $216.78	Professional		$56.97	$91.47	$216.78
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $118.68 / $258.10 / $538.29	Facility		$118.68	$258.10	$538.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $115.21 / $670.92	Professional		$79.95	$115.21	$670.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.72 / $66.72 / $66.72	Facility		$66.72	$66.72	$66.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.71 / $48.71 / $66.72	Professional		$48.71	$48.71	$66.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.15 / $128.76 / $290.62	Facility		$64.15	$128.76	$290.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.22 / $128.76 / $215.97	Professional		$64.22	$128.76	$215.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.50 / $103.89 / $114.27	Professional		$93.50	$103.89	$114.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.35 / $116.68 / $135.54	Facility		$99.35	$116.68	$135.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $101.74 / $121.99 / $135.54	Professional		$101.74	$121.99	$135.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.68 / $152.21 / $264.72	Facility		$118.68	$152.21	$264.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $129.01 / $132.36 / $132.36	Facility		$129.01	$132.36	$132.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.66 / $115.21 / $149.09	Professional		$107.66	$115.21	$149.09
United Facility/Professional Facility Modifier Low / Median / High Price $61.98 / $61.98 / $61.98	Facility		$61.98	$61.98	$61.98
United Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $54.75 / $96.84	Professional		$46.93	$54.75	$96.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.20 / $44.20 / $115.21	Professional		$44.20	$44.20	$115.21