Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.73 / $66.62 / $19,551.68	Facility		$54.73	$66.62	$19,551.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $56.12 / $70.01	Professional		$55.57	$56.12	$70.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $49.12 / $76.50 / $264.95	Facility		$49.12	$76.50	$264.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $61.13 / $226.89	Professional		$55.57	$61.13	$226.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.39 / $52.42 / $105.98	Facility		$51.39	$52.42	$105.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $55.57 / $68.15	Professional		$55.57	$55.57	$68.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $55.57 / $55.57 / $159.06	Facility		$55.57	$55.57	$159.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $55.57 / $122.03	Professional		$55.57	$55.57	$122.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.67 / $60.13 / $73.80	Professional		$54.67	$60.13	$73.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $55.57 / $90.69	Facility		$51.00	$55.57	$90.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.15 / $75.05 / $137.34	Facility		$44.15	$75.05	$137.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.29 / $65.45 / $118.29	Professional		$54.29	$65.45	$118.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $61.20 / $109.19	Facility		$51.00	$61.20	$109.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $61.13 / $66.68	Professional		$55.57	$61.13	$66.68
United Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $55.57 / $66.68	Professional		$55.57	$55.57	$66.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.39 / $55.57 / $55.57	Professional		$51.39	$55.57	$55.57