Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.88 / $77.64 / $106.37	Facility		$44.88	$77.64	$106.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $44.88 / $52.58	Professional		$43.82	$44.88	$52.58
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.16 / $50.16 / $276.11	Facility		$50.16	$50.16	$276.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $50.16 / $50.16 / $454.13	Professional		$50.16	$50.16	$454.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.88 / $44.88 / $89.76	Facility		$44.88	$44.88	$89.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $44.88 / $44.88	Professional		$44.88	$44.88	$44.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $48.36 / $115.12 / $139.88	Facility		$48.36	$115.12	$139.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.36 / $115.12 / $148.11	Professional		$48.36	$115.12	$148.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.17 / $55.17 / $75.00	Professional		$55.17	$55.17	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $50.16 / $50.16 / $104.52	Facility		$50.16	$50.16	$104.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.16 / $50.16 / $50.16	Facility		$50.16	$50.16	$50.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.16 / $50.16 / $50.16	Professional		$50.16	$50.16	$50.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $50.16 / $50.16 / $50.16	Facility		$50.16	$50.16	$50.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.65 / $50.16 / $50.16	Professional		$47.65	$50.16	$50.16
United Facility/Professional Professional Modifier Low / Median / High Price $50.16 / $50.16 / $60.19	Professional		$50.16	$50.16	$60.19