Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.70 / $123.48 / $136.75	Facility		$57.70	$123.48	$136.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.58 / $57.70 / $136.75	Professional		$45.58	$57.70	$136.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $74.87 / $193.44 / $434.49	Facility		$74.87	$193.44	$434.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $62.42 / $74.87 / $453.62	Professional		$62.42	$74.87	$453.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.62 / $61.62 / $61.62	Facility		$61.62	$61.62	$61.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.98 / $44.98 / $61.62	Professional		$44.98	$44.98	$61.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $51.41 / $86.91 / $233.43	Facility		$51.41	$86.91	$233.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.47 / $87.21 / $172.94	Professional		$51.47	$87.21	$172.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.00 / $65.56 / $72.11	Professional		$59.00	$65.56	$72.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.89 / $81.39 / $85.50	Facility		$67.89	$81.39	$85.50
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $81.23 / $85.50 / $94.05	Professional		$81.23	$85.50	$94.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.87 / $96.02 / $167.00	Facility		$74.87	$96.02	$167.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $70.98 / $70.98	Professional		$70.98	$70.98	$70.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $81.38 / $83.50 / $83.50	Facility		$81.38	$83.50	$83.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.94 / $72.68 / $94.05	Professional		$67.94	$72.68	$94.05
United Facility/Professional Professional Modifier Low / Median / High Price $37.54 / $46.93 / $77.47	Professional		$37.54	$46.93	$77.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.27 / $32.27 / $49.30	Professional		$32.27	$32.27	$49.30