Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.57 / $49.57 / $49.57	Facility		$49.57	$49.57	$49.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.32 / $49.57 / $114.47	Professional		$39.32	$49.57	$114.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $84.59 / $148.83 / $425.46	Facility		$84.59	$148.83	$425.46
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $65.30 / $84.59 / $601.58	Professional		$65.30	$84.59	$601.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $65.00	Facility		$65.00	$65.00	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.25 / $55.25 / $74.79	Professional		$55.25	$55.25	$74.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.64 / $112.80 / $209.20	Facility		$83.64	$112.80	$209.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.90 / $114.11 / $228.39	Professional		$79.90	$114.11	$228.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $80.00	Professional		$30.00	$60.00	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $87.12 / $93.28 / $108.60	Facility		$87.12	$93.28	$108.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.90 / $86.14 / $172.28	Facility		$71.90	$86.14	$172.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.90 / $86.14 / $107.68	Professional		$71.90	$86.14	$107.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $84.59 / $84.59 / $91.27	Facility		$84.59	$84.59	$91.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.34 / $74.05 / $95.83	Professional		$70.34	$74.05	$95.83
United Facility/Professional Professional Modifier Low / Median / High Price $45.56 / $50.90 / $88.09	Professional		$45.56	$50.90	$88.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.49 / $53.49 / $53.49	Professional		$53.49	$53.49	$53.49