Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.78 / $176.56 / $184.34	Facility		$77.78	$176.56	$184.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.77 / $77.78 / $176.56	Professional		$56.77	$77.78	$176.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $84.46 / $197.74 / $469.03	Facility		$84.46	$197.74	$469.03
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $68.52 / $92.82 / $668.30	Professional		$68.52	$92.82	$668.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.68 / $76.68 / $76.68	Facility		$76.68	$76.68	$76.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.98 / $55.98 / $101.75	Professional		$55.98	$55.98	$101.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $81.59 / $149.80 / $301.39	Facility		$81.59	$149.80	$301.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $153.03 / $284.69	Professional		$81.59	$153.03	$284.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.27 / $120.30 / $132.33	Professional		$108.27	$120.30	$132.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.99 / $113.09 / $131.62	Facility		$86.99	$113.09	$131.62
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $82.64 / $86.99 / $131.62	Professional		$82.64	$86.99	$131.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.70 / $97.70 / $185.81	Facility		$97.70	$97.70	$185.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.79 / $71.79 / $71.79	Professional		$71.79	$71.79	$71.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $84.46 / $84.46 / $100.69	Facility		$84.46	$84.46	$100.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.23 / $74.81 / $124.66	Professional		$70.23	$74.81	$124.66
United Facility/Professional Facility Modifier Low / Median / High Price $55.21 / $71.01 / $71.65	Facility		$55.21	$71.01	$71.65
United Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $71.65 / $119.42	Professional		$66.25	$71.65	$119.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.17 / $74.17 / $84.10	Professional		$74.17	$74.17	$84.10