Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.36 / $64.44 / $141.25	Professional		$63.36	$64.44	$141.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $599.70 / $599.70	Facility		$100.00	$599.70	$599.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $10.67 / $94.61 / $128.52	Professional		$10.67	$94.61	$128.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.94 / $78.94 / $78.94	Facility		$78.94	$78.94	$78.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $67.09 / $148.88	Professional		$67.09	$67.09	$148.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $128.52 / $128.52 / $128.52	Facility		$128.52	$128.52	$128.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.52 / $128.52 / $128.52	Professional		$128.52	$128.52	$128.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.85 / $96.36 / $128.52	Professional		$12.85	$96.36	$128.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $115.67 / $123.42 / $128.52	Facility		$115.67	$123.42	$128.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $123.42 / $126.37 / $128.52	Professional		$123.42	$126.37	$128.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.31 / $113.12 / $113.12	Facility		$11.31	$113.12	$113.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.67 / $106.68 / $228.11	Professional		$10.67	$106.68	$228.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.51 / $125.51 / $125.51	Facility		$125.51	$125.51	$125.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $8.68 / $8.68 / $10.57	Professional		$8.68	$8.68	$10.57
United Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $62.49 / $120.16	Professional		$50.39	$62.49	$120.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.39 / $75.39 / $75.39	Professional		$75.39	$75.39	$75.39