Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.91 / $123.48 / $139.62	Facility		$58.91	$123.48	$139.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.88 / $58.91 / $139.62	Professional		$48.88	$58.91	$139.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $76.44 / $211.95 / $463.13	Facility		$76.44	$211.95	$463.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $63.72 / $76.44 / $669.96	Professional		$63.72	$76.44	$669.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.62 / $64.62 / $64.62	Facility		$64.62	$64.62	$64.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.17 / $47.17 / $64.62	Professional		$47.17	$47.17	$64.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $55.05 / $93.04 / $239.18	Facility		$55.05	$93.04	$239.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.11 / $93.66 / $184.53	Professional		$55.11	$93.66	$184.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.21 / $66.91 / $73.60	Professional		$60.21	$66.91	$73.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.29 / $85.24 / $87.29	Facility		$69.29	$85.24	$87.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $74.20 / $87.29 / $100.38	Professional		$74.20	$87.29	$100.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.44 / $98.03 / $170.48	Facility		$76.44	$98.03	$170.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $72.45 / $72.45	Professional		$72.45	$72.45	$72.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $83.09 / $85.24 / $85.24	Facility		$83.09	$85.24	$85.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.34 / $74.20 / $96.02	Professional		$69.34	$74.20	$96.02
United Facility/Professional Professional Modifier Low / Median / High Price $40.27 / $46.98 / $83.09	Professional		$40.27	$46.98	$83.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.51 / $54.12 / $54.12	Professional		$52.51	$54.12	$54.12