Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.23 / $101.53 / $377.99	Facility		$61.23	$101.53	$377.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.08 / $64.48 / $101.53	Professional		$53.08	$64.48	$101.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $68.59 / $109.76 / $327.87	Facility		$68.59	$109.76	$327.87
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $149.55 / $777.00	Professional		$64.48	$149.55	$777.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.49 / $124.41 / $200.66	Facility		$47.49	$124.41	$200.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.76 / $77.09 / $100.92	Professional		$42.76	$77.09	$100.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $68.59 / $101.00 / $211.97	Facility		$68.59	$101.00	$211.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $134.40 / $214.37	Professional		$68.59	$134.40	$214.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.05 / $67.15 / $75.00	Professional		$61.05	$67.15	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.59 / $68.59 / $144.06	Facility		$68.59	$68.59	$144.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.74 / $109.76 / $205.80	Facility		$61.74	$109.76	$205.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.74 / $61.74 / $61.74	Professional		$61.74	$61.74	$61.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.03 / $112.57 / $188.65	Facility		$72.03	$112.57	$188.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.98 / $133.34 / $159.44	Professional		$79.98	$133.34	$159.44
United Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $56.07 / $98.25	Professional		$41.16	$56.07	$98.25