Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.53 / $93.53 / $93.53	Facility		$93.53	$93.53	$93.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.02 / $93.53 / $112.99	Professional		$85.02	$93.53	$112.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $128.87 / $457.19 / $457.19	Facility		$128.87	$457.19	$457.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $135.36 / $240.63 / $810.98	Professional		$135.36	$240.63	$810.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $870.49 / $870.49 / $870.49	Facility		$870.49	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.62 / $65.19 / $148.28	Professional		$28.62	$65.19	$148.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $286.52 / $286.52 / $286.52	Professional		$286.52	$286.52	$286.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $45.18 / $55.56 / $188.94	Facility		$45.18	$55.56	$188.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.97 / $115.97 / $128.87	Facility		$115.97	$115.97	$128.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.97 / $213.81 / $264.32	Professional		$142.97	$213.81	$264.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $130.28 / $183.30 / $244.21	Professional		$130.28	$183.30	$244.21
United Facility/Professional Professional Modifier Low / Median / High Price $86.25 / $129.94 / $271.30	Professional		$86.25	$129.94	$271.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $61.52 / $61.52	Professional		$61.52	$61.52	$61.52