Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.93 / $46.93 / $46.93	Facility		$46.93	$46.93	$46.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.74 / $46.93 / $52.40	Professional		$41.74	$46.93	$52.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $202.73 / $311.38 / $595.98	Facility		$202.73	$311.38	$595.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $57.75 / $86.67 / $274.20	Professional		$57.75	$86.67	$274.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.44 / $373.15 / $498.80	Facility		$234.44	$373.15	$498.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $49.95	Professional		$49.95	$49.95	$49.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $111.19 / $316.58 / $1,031.48	Facility		$111.19	$316.58	$1,031.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.66 / $111.66 / $111.66	Professional		$111.66	$111.66	$111.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $65.00	Professional		$45.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.35 / $62.05 / $63.65	Facility		$41.35	$62.05	$63.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.42 / $43.42 / $56.63	Facility		$43.42	$43.42	$56.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.71 / $86.17 / $104.19	Professional		$56.71	$86.17	$104.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $227.34 / $311.56 / $595.98	Facility		$227.34	$311.56	$595.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.57 / $65.80 / $89.15	Professional		$57.57	$65.80	$89.15
United Facility/Professional Professional Modifier Low / Median / High Price $42.55 / $49.00 / $106.77	Professional		$42.55	$49.00	$106.77