Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.73 / $107.73 / $107.73	Facility		$107.73	$107.73	$107.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $107.73 / $122.43	Professional		$97.94	$107.73	$122.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $67.64 / $121.04 / $774.00	Facility		$67.64	$121.04	$774.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $93.04 / $97.94 / $928.80	Professional		$93.04	$97.94	$928.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.40 / $92.40 / $200.34	Facility		$92.40	$92.40	$200.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $120.12	Professional		$97.94	$97.94	$120.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $97.02 / $133.10 / $217.00	Facility		$97.02	$133.10	$217.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $132.22 / $200.25	Professional		$97.02	$132.22	$200.25
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 $89.04 / $97.94 / $203.27	Facility		$89.04	$97.94	$203.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.72 / $96.12 / $171.31	Facility		$65.72	$96.12	$171.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.52 / $121.21 / $198.79	Professional		$111.52	$121.21	$198.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $120.78 / $300.74	Facility		$97.94	$120.78	$300.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.04 / $97.94 / $101.86	Professional		$93.04	$97.94	$101.86
United Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $117.53	Professional		$97.94	$97.94	$117.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $102.79	Professional		$97.94	$97.94	$102.79