Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.40 / $150.72 / $157.37	Facility		$66.40	$150.72	$157.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.06 / $66.40 / $157.37	Professional		$57.06	$66.40	$157.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $86.15 / $208.62 / $503.80	Facility		$86.15	$208.62	$503.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $84.61 / $558.26	Professional		$71.81	$84.61	$558.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.48 / $61.48 / $61.48	Facility		$61.48	$61.48	$61.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $44.88 / $61.48	Professional		$44.88	$44.88	$61.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $61.88 / $104.58 / $269.58	Facility		$61.88	$104.58	$269.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.94 / $105.47 / $208.53	Professional		$61.94	$105.47	$208.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.87 / $75.42 / $82.96	Professional		$67.87	$75.42	$82.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $78.09 / $96.08 / $101.90	Facility		$78.09	$96.08	$101.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $88.54 / $98.38 / $101.90	Professional		$88.54	$98.38	$101.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.15 / $110.49 / $192.16	Facility		$86.15	$110.49	$192.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.26 / $81.67 / $81.67	Professional		$72.26	$81.67	$81.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $93.64 / $96.08 / $96.08	Facility		$93.64	$96.08	$96.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $78.16 / $83.62 / $108.22	Professional		$78.16	$83.62	$108.22
United Facility/Professional Facility Modifier Low / Median / High Price $29.60 / $29.60 / $29.60	Facility		$29.60	$29.60	$29.60
United Facility/Professional Professional Modifier Low / Median / High Price $45.38 / $49.17 / $93.64	Professional		$45.38	$49.17	$93.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.53 / $51.53 / $59.92	Professional		$51.53	$51.53	$59.92