Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.73 / $185.55 / $193.72	Facility		$81.73	$185.55	$193.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.76 / $81.73 / $193.72	Professional		$57.76	$81.73	$193.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $110.14 / $332.54 / $551.54	Facility		$110.14	$332.54	$551.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $78.47 / $109.43 / $1,051.10	Professional		$78.47	$109.43	$1,051.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.22 / $66.22 / $66.22	Facility		$66.22	$66.22	$66.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.34 / $48.34 / $66.22	Professional		$48.34	$48.34	$66.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $63.70 / $121.48 / $289.68	Facility		$63.70	$121.48	$289.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.77 / $119.49 / $215.15	Professional		$63.77	$119.49	$215.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $86.78 / $96.43 / $106.07	Professional		$86.78	$96.43	$106.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.85 / $115.52 / $125.78	Facility		$99.85	$115.52	$125.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $113.20 / $115.52 / $125.78	Professional		$113.20	$115.52	$125.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.14 / $141.25 / $245.66	Facility		$110.14	$141.25	$245.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $119.72 / $122.83 / $122.83	Facility		$119.72	$122.83	$122.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $99.93 / $106.91 / $138.36	Professional		$99.93	$106.91	$138.36
United Facility/Professional Professional Modifier Low / Median / High Price $50.51 / $76.08 / $96.37	Professional		$50.51	$76.08	$96.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.65 / $67.65 / $106.91	Professional		$67.65	$67.65	$106.91