Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.89 / $111.89 / $111.89	Facility		$111.89	$111.89	$111.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $110.87 / $127.15	Professional		$101.72	$110.87	$127.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $101.72 / $229.98 / $515.16	Facility		$101.72	$229.98	$515.16
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $95.11 / $101.72 / $515.16	Professional		$95.11	$101.72	$515.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.96 / $95.96 / $204.36	Facility		$95.96	$95.96	$204.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $124.75	Professional		$101.72	$101.72	$124.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $101.72 / $101.72 / $259.82	Facility		$101.72	$101.72	$259.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $269.83	Professional		$101.72	$101.72	$269.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $75.00	Professional		$30.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.72 / $101.72 / $192.25	Facility		$100.72	$101.72	$192.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $176.12 / $224.57 / $224.57	Facility		$176.12	$224.57	$224.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.59 / $143.10 / $225.66	Professional		$126.59	$143.10	$225.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $101.72 / $101.72 / $101.72	Facility		$101.72	$101.72	$101.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $96.63 / $101.72 / $101.72	Professional		$96.63	$101.72	$101.72
United Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $122.06	Professional		$101.72	$101.72	$122.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $116.68	Professional		$101.72	$101.72	$116.68