Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.04 / $144.66 / $252.67	Facility		$61.04	$144.66	$252.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.59 / $61.04 / $144.66	Professional		$49.59	$61.04	$144.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $79.20 / $298.27 / $470.06	Facility		$79.20	$298.27	$470.06
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $79.20 / $942.93	Professional		$66.00	$79.20	$942.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.55 / $60.55 / $60.55	Facility		$60.55	$60.55	$60.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.20 / $44.20 / $60.55	Professional		$44.20	$44.20	$60.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $55.51 / $94.50 / $247.87	Facility		$55.51	$94.50	$247.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $94.50 / $187.84	Professional		$55.57	$94.50	$187.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $69.34 / $76.27	Professional		$62.40	$69.34	$76.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $71.80 / $88.33 / $90.45	Facility		$71.80	$88.33	$90.45
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $85.93 / $90.45 / $90.45	Professional		$85.93	$90.45	$90.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.20 / $101.58 / $176.66	Facility		$79.20	$101.58	$176.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.08 / $75.08 / $75.08	Professional		$75.08	$75.08	$75.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $86.09 / $88.33 / $88.33	Facility		$86.09	$88.33	$88.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $71.86 / $76.88 / $99.50	Professional		$71.86	$76.88	$99.50
United Facility/Professional Facility Modifier Low / Median / High Price $118.06 / $141.66 / $141.66	Facility		$118.06	$141.66	$141.66
United Facility/Professional Professional Modifier Low / Median / High Price $40.84 / $45.83 / $84.28	Professional		$40.84	$45.83	$84.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $46.84 / $53.11	Professional		$46.84	$46.84	$53.11