Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.31 / $76.38 / $131.85	Facility		$68.31	$76.38	$131.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $63.96 / $78.23	Professional		$62.10	$63.96	$78.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $67.05 / $99.48 / $314.95	Facility		$67.05	$99.48	$314.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $68.31 / $282.02	Professional		$62.10	$68.31	$282.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.58 / $62.10 / $125.98	Facility		$58.58	$62.10	$125.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $76.16	Professional		$62.10	$62.10	$76.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $69.84 / $225.81	Facility		$62.10	$69.84	$225.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $179.13	Professional		$62.10	$62.10	$179.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $69.28 / $83.83	Professional		$62.10	$69.28	$83.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.09 / $71.76 / $186.30	Facility		$62.09	$71.76	$186.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.35 / $107.28 / $187.74	Facility		$60.35	$107.28	$187.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.11 / $81.34 / $147.03	Professional		$71.11	$81.34	$147.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $66.31 / $79.58 / $147.66	Facility		$66.31	$79.58	$147.66
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $68.31 / $74.52	Professional		$62.10	$68.31	$74.52
United Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $74.52	Professional		$62.10	$62.10	$74.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $63.88	Professional		$62.10	$62.10	$63.88