Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.92 / $120.13 / $125.42	Facility		$52.92	$120.13	$125.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $52.92 / $125.42	Professional		$42.34	$52.92	$125.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $68.66 / $203.68 / $394.95	Facility		$68.66	$203.68	$394.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $57.24 / $68.66 / $443.03	Professional		$57.24	$68.66	$443.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.20 / $65.20 / $79.79	Facility		$65.20	$65.20	$79.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.60 / $47.60 / $79.79	Professional		$47.60	$47.60	$79.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.77 / $81.00 / $214.91	Facility		$47.77	$81.00	$214.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.82 / $81.00 / $160.53	Professional		$47.82	$81.00	$160.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.10 / $60.12 / $66.13	Professional		$54.10	$60.12	$66.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.25 / $75.61 / $78.41	Facility		$62.25	$75.61	$78.41
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $78.41 / $81.55	Professional		$62.30	$78.41	$81.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.66 / $88.06 / $153.13	Facility		$68.66	$88.06	$153.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.08 / $65.08 / $80.73	Professional		$65.08	$65.08	$80.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $74.63 / $76.56 / $76.56	Facility		$74.63	$76.56	$76.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $66.65 / $86.25	Professional		$62.30	$66.65	$86.25
United Facility/Professional Professional Modifier Low / Median / High Price $34.88 / $40.69 / $71.97	Professional		$34.88	$40.69	$71.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $36.43 / $45.98	Professional		$36.43	$36.43	$45.98