Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $108.64 / $113.43	Facility		$47.86	$108.64	$113.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.54 / $47.86 / $113.43	Professional		$42.54	$47.86	$113.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $135.06 / $327.13	Facility		$62.10	$135.06	$327.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $49.46 / $61.09 / $398.90	Professional		$49.46	$61.09	$398.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.77 / $40.77 / $40.77	Facility		$40.77	$40.77	$40.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.76 / $29.76 / $40.77	Professional		$29.76	$29.76	$40.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $39.13 / $70.92 / $179.06	Facility		$39.13	$70.92	$179.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.17 / $70.92 / $132.40	Professional		$39.17	$70.92	$132.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.94 / $54.38 / $59.81	Professional		$48.94	$54.38	$59.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $56.30 / $69.26 / $80.09	Facility		$56.30	$69.26	$80.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $63.83 / $70.92 / $80.09	Professional		$63.83	$70.92	$80.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $79.65 / $138.52	Facility		$62.10	$79.65	$138.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.87 / $58.87 / $73.84	Professional		$58.87	$58.87	$73.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $67.50 / $69.26 / $69.26	Facility		$67.50	$69.26	$69.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $56.35 / $60.28 / $78.01	Professional		$56.35	$60.28	$78.01
United Facility/Professional Professional Modifier Low / Median / High Price $28.76 / $33.54 / $59.34	Professional		$28.76	$33.54	$59.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.97 / $46.84 / $46.84	Professional		$36.97	$46.84	$46.84