Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.48 / $189.50 / $197.85	Facility		$83.48	$189.50	$197.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.50 / $83.48 / $197.85	Professional		$52.50	$83.48	$197.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $112.49 / $232.10 / $510.07	Facility		$112.49	$232.10	$510.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $75.58 / $109.20 / $638.51	Professional		$75.58	$109.20	$638.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.21 / $60.21 / $60.21	Facility		$60.21	$60.21	$60.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $43.95 / $60.21	Professional		$43.95	$43.95	$60.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.51 / $122.05 / $276.56	Facility		$60.51	$122.05	$276.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.58 / $122.05 / $205.22	Professional		$60.58	$122.05	$205.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.64 / $98.49 / $108.33	Professional		$88.64	$98.49	$108.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $101.98 / $115.49 / $128.47	Facility		$101.98	$115.49	$128.47
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $104.99 / $128.47 / $128.47	Professional		$104.99	$128.47	$128.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.49 / $144.28 / $250.92	Facility		$112.49	$144.28	$250.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $122.28 / $125.46 / $125.46	Facility		$122.28	$125.46	$125.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.06 / $109.20 / $141.32	Professional		$102.06	$109.20	$141.32
United Facility/Professional Professional Modifier Low / Median / High Price $48.07 / $72.48 / $91.71	Professional		$48.07	$72.48	$91.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.04 / $52.04 / $57.87	Professional		$52.04	$52.04	$57.87