Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.70 / $187.73 / $196.00	Facility		$82.70	$187.73	$196.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.41 / $82.70 / $196.00	Professional		$56.41	$82.70	$196.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $111.43 / $266.54 / $584.39	Facility		$111.43	$266.54	$584.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $86.05 / $110.17 / $842.45	Professional		$86.05	$110.17	$842.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.84 / $68.84 / $68.84	Facility		$68.84	$68.84	$68.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $50.25 / $78.34	Professional		$50.25	$50.25	$78.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.16 / $127.25 / $315.93	Facility		$69.16	$127.25	$315.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.23 / $127.25 / $234.18	Professional		$69.23	$127.25	$234.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.79 / $97.55 / $107.30	Professional		$87.79	$97.55	$107.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $101.01 / $114.53 / $127.25	Facility		$101.01	$114.53	$127.25
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $108.16 / $120.89 / $127.25	Professional		$108.16	$120.89	$127.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.43 / $142.91 / $248.54	Facility		$111.43	$142.91	$248.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $121.12 / $124.27 / $124.27	Facility		$121.12	$124.27	$124.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $101.09 / $108.16 / $139.97	Professional		$101.09	$108.16	$139.97
United Facility/Professional Professional Modifier Low / Median / High Price $52.51 / $82.44 / $104.86	Professional		$52.51	$82.44	$104.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.02 / $26.02 / $108.16	Professional		$26.02	$26.02	$108.16