Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.69 / $112.80 / $117.77	Facility		$49.69	$112.80	$117.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.14 / $49.69 / $117.77	Professional		$40.14	$49.69	$117.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $64.48 / $191.28 / $377.30	Facility		$64.48	$191.28	$377.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $53.76 / $64.48 / $472.97	Professional		$53.76	$64.48	$472.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.95 / $52.95 / $52.95	Facility		$52.95	$52.95	$52.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $38.65 / $52.95	Professional		$38.65	$38.65	$52.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $45.04 / $76.78 / $201.77	Facility		$45.04	$76.78	$201.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.09 / $76.78 / $151.43	Professional		$45.09	$76.78	$151.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.79 / $56.44 / $62.08	Professional		$50.79	$56.44	$62.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.45 / $71.67 / $73.64	Facility		$58.45	$71.67	$73.64
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $62.59 / $71.67 / $73.64	Professional		$62.59	$71.67	$73.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.48 / $82.70 / $143.82	Facility		$64.48	$82.70	$143.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.12 / $61.12 / $73.89	Professional		$61.12	$61.12	$73.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $70.09 / $71.91 / $71.91	Facility		$70.09	$71.91	$71.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.49 / $62.59 / $81.00	Professional		$58.49	$62.59	$81.00
United Facility/Professional Professional Modifier Low / Median / High Price $33.65 / $38.56 / $68.20	Professional		$33.65	$38.56	$68.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.10 / $63.49 / $63.49	Professional		$43.10	$63.49	$63.49