Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.73 / $90.09 / $172.35	Facility		$81.73	$90.09	$172.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $82.72 / $100.43	Professional		$81.90	$82.72	$100.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $76.50 / $116.99 / $394.30	Facility		$76.50	$116.99	$394.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $90.09 / $350.34	Professional		$81.90	$90.09	$350.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.26 / $79.34 / $157.72	Facility		$77.26	$79.34	$157.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $100.44	Professional		$81.90	$81.90	$100.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $81.90 / $236.57	Facility		$81.90	$81.90	$236.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $181.39	Professional		$81.90	$81.90	$181.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $86.74 / $106.46	Professional		$75.00	$86.74	$106.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $93.80 / $245.70	Facility		$81.90	$93.80	$245.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.84 / $117.04 / $214.19	Facility		$68.84	$117.04	$214.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.84 / $101.06 / $182.66	Professional		$83.84	$101.06	$182.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $77.98 / $92.94 / $166.01	Facility		$77.98	$92.94	$166.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $90.09 / $98.28	Professional		$81.90	$90.09	$98.28
United Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $98.28	Professional		$81.90	$81.90	$98.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $81.90 / $81.90	Professional		$79.34	$81.90	$81.90