Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.02 / $149.03 / $555.51	Facility		$75.02	$149.03	$555.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $71.61 / $165.73	Professional		$68.20	$71.61	$165.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $65.31 / $343.95 / $812.19	Facility		$65.31	$343.95	$812.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $81.84 / $1,771.57	Professional		$68.20	$81.84	$1,771.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.34 / $68.20 / $239.72	Facility		$64.34	$68.20	$239.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $83.64	Professional		$68.20	$68.20	$83.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $91.56 / $315.93	Facility		$68.20	$91.56	$315.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $88.66 / $196.09	Professional		$68.20	$88.66	$196.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $75.02 / $85.98	Professional		$65.48	$75.02	$85.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $81.11 / $236.64	Facility		$68.20	$81.11	$236.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.84 / $266.17 / $487.11	Facility		$101.84	$266.17	$487.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.30 / $214.34 / $387.40	Professional		$168.30	$214.34	$387.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $75.02 / $275.16 / $733.76	Facility		$75.02	$275.16	$733.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $75.02 / $81.84	Professional		$68.20	$75.02	$81.84
United Facility/Professional Facility Modifier Low / Median / High Price $98.22 / $98.22 / $98.22	Facility		$98.22	$98.22	$98.22
United Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $81.84	Professional		$68.20	$68.20	$81.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $168.30	Professional		$68.20	$68.20	$168.30