Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.85 / $140.40 / $146.58	Facility		$61.85	$140.40	$146.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.48 / $61.85 / $107.00	Professional		$46.48	$61.85	$107.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $80.25 / $190.64 / $437.39	Facility		$80.25	$190.64	$437.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $61.08 / $78.81 / $473.70	Professional		$61.08	$78.81	$473.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.60 / $58.60 / $58.60	Facility		$58.60	$58.60	$58.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.78 / $42.78 / $75.29	Professional		$42.78	$42.78	$75.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $58.90 / $100.79 / $240.00	Facility		$58.90	$100.79	$240.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.90 / $97.08 / $177.91	Professional		$58.90	$97.08	$177.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.23 / $70.26 / $77.28	Professional		$63.23	$70.26	$77.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.75 / $89.50 / $95.12	Facility		$72.75	$89.50	$95.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $87.07 / $91.65 / $95.12	Professional		$87.07	$91.65	$95.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.25 / $102.93 / $179.00	Facility		$80.25	$102.93	$179.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.08 / $76.08 / $89.50	Professional		$76.08	$76.08	$89.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $87.23 / $89.50 / $89.50	Facility		$87.23	$89.50	$89.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.81 / $77.90 / $100.82	Professional		$72.81	$77.90	$100.82
United Facility/Professional Professional Modifier Low / Median / High Price $38.71 / $41.86 / $79.87	Professional		$38.71	$41.86	$79.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.86 / $67.70 / $67.70	Professional		$50.86	$67.70	$67.70