Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.52 / $135.83 / $207.42	Facility		$87.52	$135.83	$207.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.61 / $87.52 / $207.42	Professional		$60.61	$87.52	$207.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $117.92 / $256.44 / $645.28	Facility		$117.92	$256.44	$645.28
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $95.97 / $118.36 / $799.97	Professional		$95.97	$118.36	$799.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.19 / $89.19 / $89.19	Facility		$89.19	$89.19	$89.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.11 / $65.11 / $89.19	Professional		$65.11	$65.11	$89.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $76.44 / $134.66 / $347.81	Facility		$76.44	$134.66	$347.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.52 / $134.66 / $257.35	Professional		$76.52	$134.66	$257.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $92.91 / $103.24 / $113.56	Professional		$92.91	$103.24	$113.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $106.90 / $121.21 / $134.66	Facility		$106.90	$121.21	$134.66
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $121.20 / $129.71 / $134.66	Professional		$121.20	$129.71	$134.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.92 / $151.24 / $263.02	Facility		$117.92	$151.24	$263.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $128.18 / $131.51 / $131.51	Facility		$128.18	$131.51	$131.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $106.98 / $114.47 / $148.13	Professional		$106.98	$114.47	$148.13
United Facility/Professional Professional Modifier Low / Median / High Price $60.47 / $91.08 / $115.36	Professional		$60.47	$91.08	$115.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.98 / $83.26 / $83.26	Professional		$80.98	$83.26	$83.26