Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $127.93 / $149.60	Facility		$63.10	$127.93	$149.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.99 / $63.10 / $149.55	Professional		$48.99	$63.10	$149.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $81.87 / $222.45 / $468.00	Facility		$81.87	$222.45	$468.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $68.25 / $83.44 / $596.48	Professional		$68.25	$83.44	$596.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $62.81 / $62.81	Facility		$62.81	$62.81	$62.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $45.85 / $62.81	Professional		$45.85	$45.85	$62.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $55.05 / $93.66 / $250.31	Facility		$55.05	$93.66	$250.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.11 / $95.36 / $186.18	Professional		$55.11	$95.36	$186.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.51 / $71.68 / $78.84	Professional		$64.51	$71.68	$78.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.20 / $87.48 / $93.49	Facility		$74.20	$87.48	$93.49
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $84.14 / $93.49 / $93.49	Professional		$84.14	$93.49	$93.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.87 / $104.99 / $182.60	Facility		$81.87	$104.99	$182.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.61 / $77.61 / $77.61	Professional		$77.61	$77.61	$77.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $88.99 / $91.30 / $91.30	Facility		$88.99	$91.30	$91.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.28 / $79.47 / $102.84	Professional		$74.28	$79.47	$102.84
United Facility/Professional Professional Modifier Low / Median / High Price $40.35 / $50.44 / $83.26	Professional		$40.35	$50.44	$83.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.04 / $52.04 / $52.62	Professional		$52.04	$52.04	$52.62