Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.31 / $218.56 / $3,234.87	Facility		$119.31	$218.56	$3,234.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $110.64 / $148.96	Professional		$108.47	$110.64	$148.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $204.35 / $1,578.65	Facility		$108.47	$204.35	$1,578.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $110.32 / $1,698.40	Professional		$108.47	$110.32	$1,698.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $108.47 / $329.92	Facility		$102.33	$108.47	$329.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $153.49	Professional		$108.47	$108.47	$153.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $427.00 / $1,239.69	Facility		$108.47	$427.00	$1,239.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $435.90 / $1,121.42	Professional		$108.47	$435.90	$1,121.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $120.20 / $165.45	Professional		$80.00	$120.20	$165.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $123.72 / $325.41	Facility		$108.47	$123.72	$325.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.94 / $159.43 / $239.36	Facility		$76.94	$159.43	$239.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $160.43 / $263.12	Professional		$147.60	$160.43	$263.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $163.47 / $476.55	Facility		$108.47	$163.47	$476.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $103.05 / $108.47 / $112.81	Professional		$103.05	$108.47	$112.81
United Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $130.16	Professional		$108.47	$108.47	$130.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $136.05	Professional		$108.47	$108.47	$136.05