Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.37 / $88.37 / $88.37	Facility		$88.37	$88.37	$88.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.72 / $88.37 / $196.68	Professional		$79.72	$88.37	$196.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $155.09 / $283.27 / $812.03	Facility		$155.09	$283.27	$812.03
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $18.01 / $127.78 / $193.64	Professional		$18.01	$127.78	$193.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.30 / $120.30 / $120.30	Facility		$120.30	$120.30	$120.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.26 / $120.30 / $148.61	Professional		$102.26	$120.30	$148.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $161.32 / $161.32 / $161.32	Facility		$161.32	$161.32	$161.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $161.32 / $161.32 / $161.32	Professional		$161.32	$161.32	$161.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $140.95 / $161.32 / $194.75	Professional		$140.95	$161.32	$194.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $161.32 / $169.02 / $202.82	Facility		$161.32	$169.02	$202.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $161.32 / $169.02 / $196.88	Professional		$161.32	$169.02	$196.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.51 / $155.09 / $313.24	Facility		$15.51	$155.09	$313.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.31 / $160.55 / $180.11	Professional		$13.31	$160.55	$180.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $156.62 / $156.62 / $169.00	Facility		$156.62	$156.62	$169.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $15.61 / $15.61 / $19.01	Professional		$15.61	$15.61	$19.01
United Facility/Professional Professional Modifier Low / Median / High Price $84.98 / $95.55 / $163.33	Professional		$84.98	$95.55	$163.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $130.10 / $130.10 / $130.10	Professional		$130.10	$130.10	$130.10