Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.85 / $129.47 / $250.24	Facility		$87.85	$129.47	$250.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $80.66 / $139.97	Professional		$79.86	$80.66	$139.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $84.32 / $146.63 / $760.75	Facility		$84.32	$146.63	$760.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $87.85 / $4,956.64	Professional		$79.86	$87.85	$4,956.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.76 / $75.34 / $181.29	Facility		$74.76	$75.34	$181.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $79.86 / $97.94	Professional		$79.86	$79.86	$97.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $152.46 / $388.64	Facility		$79.86	$152.46	$388.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $152.46 / $328.19	Professional		$79.86	$152.46	$328.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.18 / $70.00 / $87.84	Professional		$63.18	$70.00	$87.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $63.38 / $82.88 / $197.46	Facility		$63.38	$82.88	$197.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.15 / $177.57 / $310.75	Facility		$88.15	$177.57	$310.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.21 / $95.20 / $172.07	Professional		$83.21	$95.20	$172.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $73.31 / $109.98 / $227.29	Facility		$73.31	$109.98	$227.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $87.85 / $95.83	Professional		$79.86	$87.85	$95.83
United Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $79.86 / $95.83	Professional		$79.86	$79.86	$95.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.76 / $79.86 / $79.86	Professional		$74.76	$79.86	$79.86