Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.64 / $44.64 / $44.64	Facility		$44.64	$44.64	$44.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.38 / $44.64 / $48.60	Professional		$29.38	$44.64	$48.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $61.61 / $142.32 / $938.39	Facility		$61.61	$142.32	$938.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $45.63 / $75.81 / $267.08	Professional		$45.63	$75.81	$267.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $629.27 / $831.68 / $1,010.26	Facility		$629.27	$831.68	$1,010.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $48.90 / $48.90	Professional		$48.90	$48.90	$48.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $635.90 / $841.54 / $2,109.62	Facility		$635.90	$841.54	$2,109.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.36 / $96.36 / $96.36	Professional		$96.36	$96.36	$96.36
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 $51.15 / $62.31 / $238.37	Facility		$51.15	$62.31	$238.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.50 / $42.50 / $61.61	Facility		$42.50	$42.50	$61.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $71.98 / $88.54	Professional		$48.90	$71.98	$88.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47.78 / $679.00 / $1,328.33	Facility		$47.78	$679.00	$1,328.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $51.28 / $62.52 / $87.27	Professional		$51.28	$62.52	$87.27
United Facility/Professional Professional Modifier Low / Median / High Price $21.34 / $29.19 / $89.29	Professional		$21.34	$29.19	$89.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.54 / $134.54 / $134.54	Professional		$134.54	$134.54	$134.54