Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.42 / $107.64 / $260.35	Facility		$44.42	$107.64	$260.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.50 / $39.31 / $150.52	Professional		$32.50	$39.31	$150.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $49.61 / $77.54 / $276.58	Facility		$49.61	$77.54	$276.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.53 / $93.90 / $354.38	Professional		$42.53	$93.90	$354.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.14 / $103.35 / $138.19	Facility		$49.14	$103.35	$138.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.93 / $52.87 / $66.81	Professional		$24.93	$52.87	$66.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $46.50 / $59.06 / $134.50	Facility		$46.50	$59.06	$134.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.25 / $69.45 / $131.13	Professional		$47.25	$69.45	$131.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $46.25 / $75.00	Professional		$42.05	$46.25	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $47.25 / $99.23	Facility		$47.25	$47.25	$99.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $82.69 / $165.38	Facility		$47.25	$82.69	$165.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.53 / $59.06 / $71.34	Professional		$42.53	$59.06	$71.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $49.61 / $77.54 / $129.94	Facility		$49.61	$77.54	$129.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.26 / $92.03 / $109.91	Professional		$52.26	$92.03	$109.91
United Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $56.70 / $56.70	Facility		$47.25	$56.70	$56.70
United Facility/Professional Professional Modifier Low / Median / High Price $19.85 / $19.85 / $52.92	Professional		$19.85	$19.85	$52.92