Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.92 / $107.92 / $107.92	Facility		$107.92	$107.92	$107.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $107.92 / $109.44	Professional		$98.11	$107.92	$109.44
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $98.11 / $254.16 / $1,059.00	Facility		$98.11	$254.16	$1,059.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $98.11 / $1,270.80	Professional		$98.11	$98.11	$1,270.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.55 / $92.55 / $188.52	Facility		$92.55	$92.55	$188.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $98.11 / $120.32	Professional		$98.11	$98.11	$120.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $98.11 / $98.11 / $132.44	Facility		$98.11	$98.11	$132.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $98.11 / $122.64	Professional		$98.11	$98.11	$122.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $98.10 / $100.40 / $203.62	Facility		$98.10	$100.40	$203.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.22 / $234.39 / $234.39	Facility		$141.22	$234.39	$234.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.51 / $114.75 / $180.95	Professional		$101.51	$114.75	$180.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $98.11 / $98.11 / $98.11	Facility		$98.11	$98.11	$98.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.20 / $98.11 / $98.11	Professional		$93.20	$98.11	$98.11
United Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $98.11 / $117.73	Professional		$98.11	$98.11	$117.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.57 / $98.11 / $98.11	Professional		$93.57	$98.11	$98.11