Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.81 / $123.71 / $377.45	Facility		$65.81	$123.71	$377.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.53 / $57.15 / $169.60	Professional		$39.53	$57.15	$169.60
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $84.17 / $84.17 / $84.17	Professional	CQ	$84.17	$84.17	$84.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $89.01 / $139.13 / $316.37	Facility		$89.01	$139.13	$316.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $65.90 / $107.92 / $587.85	Professional		$65.90	$107.92	$587.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $108.00 / $118.00	Facility		$90.00	$108.00	$118.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.10 / $71.26 / $172.49	Professional		$42.10	$71.26	$172.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $49.28 / $75.53 / $159.18	Facility		$49.28	$75.53	$159.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.28 / $75.53 / $142.63	Professional		$49.28	$75.53	$142.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.93 / $98.82 / $174.58	Professional		$18.93	$98.82	$174.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $88.35 / $132.47 / $140.03	Facility		$88.35	$132.47	$140.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.41 / $125.82 / $185.93	Facility		$92.41	$125.82	$185.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.02 / $130.58 / $174.57	Professional		$94.02	$130.58	$174.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $86.96 / $104.36 / $146.87	Facility		$86.96	$104.36	$146.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.77 / $72.09 / $120.13	Professional		$67.77	$72.09	$120.13
United Facility/Professional Professional Modifier Low / Median / High Price $55.53 / $60.27 / $167.75	Professional		$55.53	$60.27	$167.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.13 / $76.73 / $76.73	Professional		$69.13	$76.73	$76.73