Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.81 / $75.81 / $75.81	Facility		$75.81	$75.81	$75.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.66 / $75.81 / $170.99	Professional		$68.66	$75.81	$170.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $122.67 / $270.08 / $652.11	Facility		$122.67	$270.08	$652.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $20.57 / $102.98 / $175.00	Professional		$20.57	$102.98	$175.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.60 / $96.60 / $96.60	Facility		$96.60	$96.60	$96.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.11 / $96.60 / $119.33	Professional		$82.11	$96.60	$119.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $126.35 / $126.35 / $126.35	Facility		$126.35	$126.35	$126.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $126.35 / $126.35 / $126.35	Professional		$126.35	$126.35	$126.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $75.00 / $197.14	Professional		$17.25	$75.00	$197.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $126.35 / $137.31 / $191.29	Facility		$126.35	$137.31	$191.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $126.35 / $137.31 / $185.72	Professional		$126.35	$137.31	$185.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.66 / $133.05 / $266.10	Facility		$13.66	$133.05	$266.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.43 / $118.99 / $141.07	Professional		$10.43	$118.99	$141.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $122.67 / $122.67 / $144.94	Facility		$122.67	$122.67	$144.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $16.89 / $20.57	Professional		$16.89	$16.89	$20.57
United Facility/Professional Professional Modifier Low / Median / High Price $71.19 / $91.66 / $136.76	Professional		$71.19	$91.66	$136.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $113.45 / $113.45 / $113.45	Professional		$113.45	$113.45	$113.45