Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.44 / $182.60 / $190.64	Facility		$80.44	$182.60	$190.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.22 / $80.44 / $190.64	Professional		$64.22	$80.44	$190.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $108.39 / $235.72 / $544.75	Facility		$108.39	$235.72	$544.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $88.16 / $136.16 / $906.60	Professional		$88.16	$136.16	$906.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.70 / $100.70 / $100.70	Facility		$100.70	$100.70	$100.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $85.60 / $100.70	Professional		$85.60	$85.60	$100.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $75.36 / $128.69 / $339.19	Facility		$75.36	$128.69	$339.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.67 / $130.86 / $240.80	Professional		$79.67	$130.86	$240.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $116.65 / $131.39	Professional		$104.98	$116.65	$131.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $111.40 / $123.78 / $136.16	Facility		$111.40	$123.78	$136.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $88.15 / $98.33 / $98.33	Professional		$88.15	$98.33	$98.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.39 / $139.01 / $241.76	Facility		$108.39	$139.01	$241.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $117.82 / $120.88 / $120.88	Facility		$117.82	$120.88	$120.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $90.36 / $136.16 / $136.16	Professional		$90.36	$136.16	$136.16
United Facility/Professional Professional Modifier Low / Median / High Price $56.53 / $75.38 / $107.85	Professional		$56.53	$75.38	$107.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $105.21 / $105.21 / $332.50	Professional		$105.21	$105.21	$332.50