Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.90 / $71.39 / $153.81	Facility		$59.90	$71.39	$153.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.60 / $64.90 / $153.81	Professional		$45.60	$64.90	$153.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $84.20 / $183.12 / $383.48	Facility		$84.20	$183.12	$383.48
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $55.22 / $81.73 / $475.99	Professional		$55.22	$81.73	$475.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.45 / $46.45 / $46.45	Facility		$46.45	$46.45	$46.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.90 / $33.90 / $46.45	Professional		$33.90	$33.90	$46.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.84 / $91.35 / $249.04	Facility		$47.84	$91.35	$249.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $91.35 / $153.08	Professional		$48.00	$91.35	$153.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $73.72 / $81.09	Professional		$66.34	$73.72	$81.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $76.34 / $86.54 / $96.16	Facility		$76.34	$86.54	$96.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $81.43 / $96.16 / $96.16	Professional		$81.43	$96.16	$96.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.20 / $108.00 / $187.82	Facility		$84.20	$108.00	$187.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.46 / $79.81 / $79.81	Professional		$61.46	$79.81	$79.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $91.53 / $93.91 / $93.91	Facility		$91.53	$93.91	$93.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $76.39 / $81.73 / $105.78	Professional		$76.39	$81.73	$105.78
United Facility/Professional Professional Modifier Low / Median / High Price $33.27 / $35.97 / $68.65	Professional		$33.27	$35.97	$68.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.63 / $41.63 / $42.24	Professional		$41.63	$41.63	$42.24