Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.35 / $98.35 / $98.35	Facility		$98.35	$98.35	$98.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $98.35 / $101.49	Professional		$89.41	$98.35	$101.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $89.41 / $191.25 / $384.93	Facility		$89.41	$191.25	$384.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $436.14	Professional		$89.41	$89.41	$436.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.35 / $84.35 / $184.06	Facility		$84.35	$84.35	$184.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $109.65	Professional		$89.41	$89.41	$109.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $89.41 / $89.41 / $120.70	Facility		$89.41	$89.41	$120.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $120.70	Professional		$89.41	$89.41	$120.70
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 $83.49 / $89.41 / $185.56	Facility		$83.49	$89.41	$185.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.59 / $186.75 / $186.75	Facility		$131.59	$186.75	$186.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.58 / $106.91 / $168.59	Professional		$94.58	$106.91	$168.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $89.41 / $89.41 / $89.41	Facility		$89.41	$89.41	$89.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $84.94 / $89.41 / $89.41	Professional		$84.94	$89.41	$89.41
United Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $107.29	Professional		$89.41	$89.41	$107.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.18 / $89.41 / $89.41	Professional		$87.18	$89.41	$89.41