Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.61 / $203.73 / $905.35	Facility		$152.61	$203.73	$905.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $152.61 / $208.11	Professional		$138.74	$152.61	$208.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $104.91 / $163.62 / $612.61	Facility		$104.91	$163.62	$612.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $129.72 / $138.74 / $1,448.75	Professional		$129.72	$138.74	$1,448.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.88 / $130.88 / $272.74	Facility		$130.88	$130.88	$272.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $138.74 / $170.15	Professional		$138.74	$138.74	$170.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.74 / $196.28 / $361.00	Facility		$138.74	$196.28	$361.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $201.65 / $361.00	Professional		$138.74	$201.65	$361.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $136.18 / $190.65	Professional		$60.00	$136.18	$190.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $136.18 / $138.74 / $262.22	Facility		$136.18	$138.74	$262.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.65 / $130.40 / $234.58	Facility		$100.65	$130.40	$234.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.54 / $163.62 / $268.33	Professional		$150.54	$163.62	$268.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $127.06 / $138.74 / $139.77	Facility		$127.06	$138.74	$139.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.80 / $138.74 / $138.74	Professional		$131.80	$138.74	$138.74
United Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $138.74 / $166.49	Professional		$138.74	$138.74	$166.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $138.74 / $138.75	Professional		$138.74	$138.74	$138.75