Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.61 / $106.79 / $273.24	Facility		$46.61	$106.79	$273.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.61 / $46.61 / $102.03	Professional		$46.61	$46.61	$102.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $52.07 / $86.78 / $235.55	Facility		$52.07	$86.78	$235.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.89 / $96.67 / $371.93	Professional		$48.89	$96.67	$371.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.03 / $89.93 / $145.04	Facility		$34.03	$89.93	$145.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.94 / $55.75 / $67.45	Professional		$30.94	$55.75	$67.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $49.59 / $72.98 / $169.68	Facility		$49.59	$72.98	$169.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.59 / $87.75 / $153.35	Professional		$49.59	$87.75	$153.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.59 / $49.59 / $104.14	Facility		$49.59	$49.59	$104.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.59 / $86.78 / $148.77	Facility		$49.59	$86.78	$148.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.63 / $61.99 / $74.88	Professional		$44.63	$61.99	$74.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $52.07 / $81.81 / $136.37	Facility		$52.07	$81.81	$136.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.82 / $96.30 / $115.33	Professional		$57.82	$96.30	$115.33
United Facility/Professional Facility Modifier Low / Median / High Price $49.59 / $59.51 / $59.51	Facility		$49.59	$59.51	$59.51
United Facility/Professional Professional Modifier Low / Median / High Price $20.83 / $28.37 / $55.54	Professional		$20.83	$28.37	$55.54