Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.57 / $126.96 / $360.00	Facility		$53.57	$126.96	$360.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.47 / $53.57 / $92.68	Professional		$45.47	$53.57	$92.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $69.51 / $209.42 / $399.39	Facility		$69.51	$209.42	$399.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $57.95 / $69.51 / $662.00	Professional		$57.95	$69.51	$662.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.76 / $35.76 / $48.98	Professional		$35.76	$35.76	$48.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.77 / $81.00 / $217.50	Facility		$47.77	$81.00	$217.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.82 / $81.00 / $160.53	Professional		$47.82	$81.00	$160.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.76 / $60.85 / $66.93	Professional		$54.76	$60.85	$66.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $63.00 / $77.52 / $100.97	Facility		$63.00	$77.52	$100.97
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $63.06 / $79.38 / $100.97	Professional		$63.06	$79.38	$100.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.51 / $89.15 / $155.04	Facility		$69.51	$89.15	$155.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.89 / $65.89 / $65.89	Professional		$65.89	$65.89	$65.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $75.56 / $77.52 / $77.52	Facility		$75.56	$77.52	$77.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.06 / $67.47 / $87.32	Professional		$63.06	$67.47	$87.32
United Facility/Professional Professional Modifier Low / Median / High Price $34.93 / $37.84 / $72.08	Professional		$34.93	$37.84	$72.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.63 / $46.84 / $46.84	Professional		$45.63	$46.84	$46.84