Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.94 / $304.07 / $317.45	Facility		$133.94	$304.07	$317.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.87 / $133.94 / $317.45	Professional		$96.87	$133.94	$317.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $180.49 / $397.62 / $1,050.89	Facility		$180.49	$397.62	$1,050.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $150.47 / $184.64 / $1,232.30	Professional		$150.47	$184.64	$1,232.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.98 / $126.98 / $126.98	Facility		$126.98	$126.98	$126.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.70 / $92.70 / $149.82	Professional		$92.70	$92.70	$149.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $121.03 / $206.12 / $551.25	Facility		$121.03	$206.12	$551.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.16 / $210.24 / $408.78	Professional		$121.16	$210.24	$408.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $142.20 / $158.01 / $173.81	Professional		$142.20	$158.01	$173.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $163.60 / $193.74 / $206.12	Facility		$163.60	$193.74	$206.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $185.51 / $206.12 / $226.73	Professional		$185.51	$206.12	$226.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.49 / $231.48 / $402.58	Facility		$180.49	$231.48	$402.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $196.19 / $201.29 / $201.29	Facility		$196.19	$201.29	$201.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $163.74 / $175.20 / $226.73	Professional		$163.74	$175.20	$226.73
United Facility/Professional Facility Modifier Low / Median / High Price $120.51 / $120.51 / $120.51	Facility		$120.51	$120.51	$120.51
United Facility/Professional Professional Modifier Low / Median / High Price $96.06 / $144.09 / $183.27	Professional		$96.06	$144.09	$183.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $56.73 / $175.20	Professional		$56.73	$56.73	$175.20