Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.78 / $226.50 / $236.48	Facility		$99.78	$226.50	$236.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.38 / $99.78 / $236.48	Professional		$93.38	$99.78	$236.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $134.44 / $292.38 / $799.68	Facility		$134.44	$292.38	$799.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $112.08 / $134.37 / $1,019.46	Professional		$112.08	$134.37	$1,019.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.32 / $99.32 / $99.32	Facility		$99.32	$99.32	$99.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $72.50 / $99.32	Professional		$72.50	$72.50	$99.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $96.46 / $163.02 / $420.74	Facility		$96.46	$163.02	$420.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.56 / $164.54 / $326.02	Professional		$96.56	$164.54	$326.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.93 / $117.71 / $129.48	Professional		$105.93	$117.71	$129.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $121.88 / $149.94 / $204.71	Facility		$121.88	$149.94	$204.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $121.98 / $153.54 / $204.71	Professional		$121.98	$153.54	$204.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.44 / $172.43 / $299.88	Facility		$134.44	$172.43	$299.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $146.13 / $149.94 / $149.94	Facility		$146.13	$149.94	$149.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $121.98 / $130.51 / $168.89	Professional		$121.98	$130.51	$168.89
United Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $114.90 / $146.13	Professional		$76.59	$114.90	$146.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $46.84 / $93.24	Professional		$46.84	$46.84	$93.24