Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.75 / $186.49 / $301.52	Facility		$61.75	$186.49	$301.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.14 / $52.62 / $90.21	Professional		$48.14	$52.62	$90.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $68.97 / $107.80 / $229.92	Facility		$68.97	$107.80	$229.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $128.44 / $492.68	Professional		$56.98	$128.44	$492.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.19 / $131.97 / $170.80	Facility		$23.19	$131.97	$170.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $69.58 / $89.79	Professional		$33.97	$69.58	$89.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.79 / $82.80 / $203.32	Facility		$64.79	$82.80	$203.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.69 / $96.56 / $181.92	Professional		$65.69	$96.56	$181.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.46 / $64.30 / $75.00	Professional		$58.46	$64.30	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $65.69 / $65.69 / $137.94	Facility		$65.69	$65.69	$137.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.12 / $114.30 / $197.07	Facility		$59.12	$114.30	$197.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.12 / $82.11 / $99.19	Professional		$59.12	$82.11	$99.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $68.97 / $107.80 / $180.65	Facility		$68.97	$107.80	$180.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.65 / $127.96 / $152.47	Professional		$72.65	$127.96	$152.47
United Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $28.15 / $73.56	Professional		$27.59	$28.15	$73.56