Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.14 / $261.37 / $272.88	Facility		$115.14	$261.37	$272.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.97 / $115.14 / $421.00	Professional		$84.97	$115.14	$421.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $155.15 / $320.11 / $771.31	Facility		$155.15	$320.11	$771.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $113.37 / $153.09 / $996.17	Professional		$113.37	$153.09	$996.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.54 / $97.54 / $97.54	Facility		$97.54	$97.54	$97.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.20 / $71.20 / $97.54	Professional		$71.20	$71.20	$97.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.45 / $175.06 / $416.25	Facility		$91.45	$175.06	$416.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.55 / $169.76 / $309.48	Professional		$91.55	$169.76	$309.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.25 / $135.84 / $149.42	Professional		$122.25	$135.84	$149.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $140.66 / $169.94 / $177.18	Facility		$140.66	$169.94	$177.18
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $150.60 / $169.94 / $177.18	Professional		$150.60	$169.94	$177.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $155.15 / $198.98 / $346.06	Facility		$155.15	$198.98	$346.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $168.65 / $173.03 / $173.03	Facility		$168.65	$173.03	$173.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $140.77 / $150.60 / $194.90	Professional		$140.77	$150.60	$194.90
United Facility/Professional Professional Modifier Low / Median / High Price $72.62 / $108.93 / $138.55	Professional		$72.62	$108.93	$138.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.26 / $83.26 / $150.60	Professional		$83.26	$83.26	$150.60