Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.99 / $342.75 / $357.85	Facility		$150.99	$342.75	$357.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.36 / $150.99 / $357.85	Professional		$121.36	$150.99	$357.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $203.45 / $443.77 / $1,122.97	Facility		$203.45	$443.77	$1,122.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $202.14 / $1,327.55	Professional		$161.63	$202.14	$1,327.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.89 / $170.89 / $170.89	Facility		$170.89	$170.89	$170.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.75 / $124.75 / $170.89	Professional		$124.75	$124.75	$170.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $127.40 / $232.35 / $579.37	Facility		$127.40	$232.35	$579.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.54 / $232.35 / $429.47	Professional		$127.54	$232.35	$429.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $160.30 / $178.12 / $195.93	Professional		$160.30	$178.12	$195.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $184.43 / $226.90 / $242.72	Facility		$184.43	$226.90	$242.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $197.50 / $232.35 / $242.72	Professional		$197.50	$232.35	$242.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.45 / $260.94 / $453.80	Facility		$203.45	$260.94	$453.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $221.15 / $226.90 / $226.90	Facility		$221.15	$226.90	$226.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $184.58 / $197.50 / $255.59	Professional		$184.58	$197.50	$255.59
United Facility/Professional Professional Modifier Low / Median / High Price $100.96 / $152.12 / $192.63	Professional		$100.96	$152.12	$192.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.63 / $41.63 / $197.50	Professional		$41.63	$41.63	$197.50