Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.88 / $132.00 / $285.61	Facility		$110.88	$132.00	$285.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.55 / $125.82 / $422.00	Professional		$94.55	$125.82	$422.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $163.25 / $480.00 / $889.53	Facility		$163.25	$480.00	$889.53
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $103.75 / $162.19 / $961.74	Professional		$103.75	$162.19	$961.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.63 / $106.63 / $121.71	Facility		$106.63	$106.63	$121.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $77.84 / $121.71	Professional		$77.84	$77.84	$121.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $107.38 / $186.43 / $488.43	Facility		$107.38	$186.43	$488.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.49 / $188.72 / $362.44	Professional		$107.49	$188.72	$362.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $128.64 / $142.94 / $157.23	Professional		$128.64	$142.94	$157.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $148.00 / $182.06 / $193.12	Facility		$148.00	$182.06	$193.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $167.79 / $186.43 / $193.12	Professional		$167.79	$186.43	$193.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $163.25 / $209.37 / $364.12	Facility		$163.25	$209.37	$364.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $177.45 / $182.06 / $182.06	Facility		$177.45	$182.06	$182.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $148.12 / $158.47 / $205.07	Professional		$148.12	$158.47	$205.07
United Facility/Professional Professional Modifier Low / Median / High Price $78.72 / $85.28 / $162.41	Professional		$78.72	$85.28	$162.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $103.75 / $114.90 / $114.90	Professional		$103.75	$114.90	$114.90