Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.09 / $145.09 / $145.09	Facility		$145.09	$145.09	$145.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $145.09 / $164.87	Professional		$131.90	$145.09	$164.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $382.50 / $637.37	Facility		$131.90	$382.50	$637.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $2,287.69	Professional		$131.90	$131.90	$2,287.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.43 / $124.43 / $267.32	Facility		$124.43	$124.43	$267.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $161.76	Professional		$131.90	$131.90	$161.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $131.90 / $178.06	Facility		$131.90	$131.90	$178.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $178.06	Professional		$131.90	$131.90	$178.06
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 $131.90 / $142.86 / $266.58	Facility		$131.90	$142.86	$266.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $217.90 / $373.50 / $373.50	Facility		$217.90	$373.50	$373.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $156.62 / $177.05 / $279.19	Professional		$156.62	$177.05	$279.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $131.90 / $131.90	Facility		$131.90	$131.90	$131.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.31 / $131.90 / $131.90	Professional		$125.31	$131.90	$131.90
United Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $158.28	Professional		$131.90	$131.90	$158.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $144.36	Professional		$131.90	$131.90	$144.36