Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.22 / $63.26 / $111.07	Facility		$49.22	$63.26	$111.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.94 / $58.08 / $71.88	Professional		$53.94	$58.08	$71.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $53.83 / $85.00 / $224.97	Facility		$53.83	$85.00	$224.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $54.63 / $57.51 / $309.22	Professional		$54.63	$57.51	$309.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.25 / $54.25 / $100.08	Facility		$54.25	$54.25	$100.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.51 / $57.51 / $70.53	Professional		$57.51	$57.51	$70.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $20.81 / $57.51 / $91.35	Facility		$20.81	$57.51	$91.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.04 / $57.51 / $94.15	Professional		$26.04	$57.51	$94.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.40 / $58.74 / $75.00	Professional		$53.40	$58.74	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $53.40 / $65.09 / $160.19	Facility		$53.40	$65.09	$160.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.51 / $52.51 / $53.83	Facility		$52.51	$52.51	$53.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.83 / $56.24 / $98.54	Professional		$53.83	$56.24	$98.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.51 / $57.51 / $57.51	Facility		$57.51	$57.51	$57.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.63 / $57.51 / $59.81	Professional		$54.63	$57.51	$59.81
United Facility/Professional Professional Modifier Low / Median / High Price $57.51 / $57.51 / $59.24	Professional		$57.51	$57.51	$59.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.95 / $57.51 / $57.51	Professional		$50.95	$57.51	$57.51