Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.27 / $88.14 / $236.05	Facility		$40.27	$88.14	$236.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.27 / $40.27 / $88.14	Professional		$40.27	$40.27	$88.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $44.98 / $74.97 / $204.03	Facility		$44.98	$74.97	$204.03
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.45 / $93.39 / $352.23	Professional		$42.45	$93.39	$352.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.64 / $77.68 / $125.33	Facility		$29.64	$77.68	$125.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.75 / $48.10 / $58.52	Professional		$26.75	$48.10	$58.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $62.97 / $133.00	Facility		$42.84	$62.97	$133.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $75.59 / $133.00	Professional		$42.84	$75.59	$133.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.13 / $41.94 / $75.00	Professional		$38.13	$41.94	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $42.84 / $89.96	Facility		$42.84	$42.84	$89.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $74.97 / $128.52	Facility		$42.84	$74.97	$128.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.56 / $38.56 / $38.56	Professional		$38.56	$38.56	$38.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $44.98 / $70.69 / $117.81	Facility		$44.98	$70.69	$117.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $83.42 / $99.85	Professional		$49.95	$83.42	$99.85
United Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $24.51 / $47.98	Professional		$17.98	$24.51	$47.98