Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.33 / $107.79 / $154.83	Facility		$65.33	$107.79	$154.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.26 / $65.33 / $76.55	Professional		$62.26	$65.33	$76.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $73.02 / $73.02 / $288.23	Facility		$73.02	$73.02	$288.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $65.72 / $73.02 / $345.87	Professional		$65.72	$73.02	$345.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.33 / $65.33 / $130.66	Facility		$65.33	$65.33	$130.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.33 / $65.33 / $65.33	Professional		$65.33	$65.33	$65.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $37.20 / $91.57 / $136.00	Facility		$37.20	$91.57	$136.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $92.98 / $137.53	Professional		$37.20	$92.98	$137.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $80.32	Professional		$75.00	$75.00	$80.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $73.02 / $73.02 / $90.45	Facility		$73.02	$73.02	$90.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.02 / $73.02 / $73.02	Facility		$73.02	$73.02	$73.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.02 / $73.02 / $73.02	Professional		$73.02	$73.02	$73.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $73.02 / $73.02 / $73.02	Facility		$73.02	$73.02	$73.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $73.02 / $73.02	Professional		$69.37	$73.02	$73.02
United Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $64.05 / $76.86	Professional		$64.05	$64.05	$76.86