Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.80 / $131.80 / $131.80	Facility		$131.80	$131.80	$131.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.80 / $149.24 / $302.39	Professional		$131.80	$149.24	$302.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $315.85 / $462.50 / $1,081.17	Facility		$315.85	$462.50	$1,081.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $191.77 / $197.90 / $1,692.08	Professional		$191.77	$197.90	$1,692.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.26 / $94.26 / $94.26	Professional		$94.26	$94.26	$94.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $184.45 / $327.54 / $475.82	Facility		$184.45	$327.54	$475.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $188.43 / $328.56 / $497.87	Professional		$188.43	$328.56	$497.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $203.04 / $231.02	Professional		$30.00	$203.04	$231.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $225.61 / $231.02 / $254.12	Facility		$225.61	$231.02	$254.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $183.53 / $183.53 / $183.53	Professional		$183.53	$183.53	$183.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $202.29 / $404.58 / $600.12	Facility		$202.29	$404.58	$600.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.77 / $225.61 / $259.45	Professional		$191.77	$225.61	$259.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.55 / $196.37 / $231.02	Professional		$186.55	$196.37	$231.02
United Facility/Professional Professional Modifier Low / Median / High Price $97.97 / $117.82 / $186.91	Professional		$97.97	$117.82	$186.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $196.37 / $196.37 / $231.02	Professional		$196.37	$196.37	$231.02