Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $51.13 / $114.81	Professional		$46.00	$51.13	$114.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $87.52 / $435.85 / $435.85	Facility		$87.52	$435.85	$435.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $11.76 / $73.63 / $127.41	Professional		$11.76	$73.63	$127.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.78 / $60.78 / $81.37	Facility		$60.78	$60.78	$81.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.66 / $51.66 / $109.50	Professional		$51.66	$51.66	$109.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $90.14 / $90.14 / $90.14	Facility		$90.14	$90.14	$90.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.14 / $90.14 / $90.14	Professional		$90.14	$90.14	$90.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $109.66 / $120.62	Professional		$75.00	$109.66	$120.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $90.14 / $92.00 / $137.33	Facility		$90.14	$92.00	$137.33
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $90.14 / $90.14 / $120.14	Professional		$90.14	$90.14	$120.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.97 / $89.73 / $122.53	Facility		$8.97	$89.73	$122.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.44 / $74.39 / $100.65	Professional		$7.44	$74.39	$100.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $87.52 / $87.52 / $87.52	Facility		$87.52	$87.52	$87.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $9.66 / $9.66 / $11.76	Professional		$9.66	$9.66	$11.76
United Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $59.65 / $91.26	Professional		$47.52	$59.65	$91.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $73.63 / $73.63 / $101.96	Professional		$73.63	$73.63	$101.96