Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.69 / $130.69 / $130.69	Facility		$130.69	$130.69	$130.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $130.69 / $130.69	Professional		$123.00	$130.69	$130.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $59.14 / $97.86 / $267.19	Facility		$59.14	$97.86	$267.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $71.25 / $161.16 / $320.63	Professional		$71.25	$161.16	$320.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.12 / $130.69 / $130.69	Facility		$121.12	$130.69	$130.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.69 / $130.69 / $130.69	Professional		$130.69	$130.69	$130.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $188.60 / $188.60 / $188.60	Professional		$188.60	$188.60	$188.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $94.60 / $115.24 / $115.24	Facility		$94.60	$115.24	$115.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.14 / $59.14 / $60.56	Facility		$59.14	$59.14	$60.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.86 / $60.56 / $64.13	Professional		$54.86	$60.56	$64.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $98.04 / $119.64 / $161.16	Professional		$98.04	$119.64	$161.16
United Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $128.13 / $153.76	Professional		$128.13	$128.13	$153.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $57.00 / $57.00	Professional		$57.00	$57.00	$57.00