Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.52 / $221.37 / $312.56	Facility		$97.52	$221.37	$312.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.60 / $97.52 / $231.12	Professional		$62.60	$97.52	$231.12
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $131.41 / $285.77 / $682.16	Facility		$131.41	$285.77	$682.16
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $101.98 / $129.68 / $790.32	Professional		$101.98	$129.68	$790.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.25 / $99.25 / $99.25	Facility		$99.25	$99.25	$99.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $72.45 / $99.25	Professional		$72.45	$72.45	$99.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $78.70 / $150.07 / $359.06	Facility		$78.70	$150.07	$359.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.80 / $144.10 / $265.62	Professional		$78.80	$144.10	$265.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $103.54 / $115.05 / $126.55	Professional		$103.54	$115.05	$126.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $119.14 / $135.06 / $150.07	Facility		$119.14	$135.06	$150.07
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $125.20 / $150.07 / $150.07	Professional		$125.20	$150.07	$150.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.41 / $168.53 / $293.10	Facility		$131.41	$168.53	$293.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $142.84 / $146.55 / $146.55	Facility		$142.84	$146.55	$146.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $119.22 / $127.56 / $165.08	Professional		$119.22	$127.56	$165.08
United Facility/Professional Facility Modifier Low / Median / High Price $1.00 / $62.46 / $82.54	Facility		$1.00	$62.46	$82.54
United Facility/Professional Professional Modifier Low / Median / High Price $62.46 / $94.08 / $119.17	Professional		$62.46	$94.08	$119.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $76.13 / $78.06 / $78.06	Professional		$76.13	$78.06	$78.06