Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.28 / $300.66 / $3,150.87	Facility		$166.28	$300.66	$3,150.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $166.28 / $541.29	Professional		$151.16	$166.28	$541.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $151.16 / $340.68 / $699.05	Facility		$151.16	$340.68	$699.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $150.33 / $151.16 / $699.05	Professional		$150.33	$151.16	$699.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.61 / $142.61 / $316.66	Facility		$142.61	$142.61	$316.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $185.39	Professional		$151.16	$151.16	$185.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $151.16 / $247.17 / $424.70	Facility		$151.16	$247.17	$424.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $258.17 / $424.70	Professional		$151.16	$258.17	$424.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $165.36 / $174.16	Professional		$75.00	$165.36	$174.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $150.33 / $187.91 / $453.51	Facility		$150.33	$187.91	$453.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $238.99 / $332.66 / $332.66	Facility		$238.99	$332.66	$332.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.78 / $194.18 / $306.20	Professional		$171.78	$194.18	$306.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $151.16 / $151.16 / $151.16	Facility		$151.16	$151.16	$151.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $143.61 / $151.16 / $151.16	Professional		$143.61	$151.16	$151.16
United Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $181.40	Professional		$151.16	$151.16	$181.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $158.33	Professional		$151.16	$151.16	$158.33