Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.45 / $119.06 / $124.31	Facility		$52.45	$119.06	$124.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.27 / $52.45 / $124.31	Professional		$36.27	$52.45	$124.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $68.05 / $147.99 / $310.38	Facility		$68.05	$147.99	$310.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $45.59 / $66.05 / $384.66	Professional		$45.59	$66.05	$384.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.57 / $38.57 / $38.57	Facility		$38.57	$38.57	$38.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $28.16 / $39.34	Professional		$28.16	$28.16	$39.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.85 / $73.81 / $165.93	Facility		$36.85	$73.81	$165.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.89 / $73.81 / $123.29	Professional		$36.89	$73.81	$123.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.62 / $59.58 / $65.53	Professional		$53.62	$59.58	$65.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.69 / $69.94 / $77.70	Facility		$61.69	$69.94	$77.70
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $61.74 / $73.81 / $77.70	Professional		$61.74	$73.81	$77.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.05 / $87.27 / $151.78	Facility		$68.05	$87.27	$151.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.51 / $64.51 / $74.51	Professional		$64.51	$64.51	$74.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $73.97 / $75.89 / $75.89	Facility		$73.97	$75.89	$75.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.74 / $66.05 / $85.48	Professional		$61.74	$66.05	$85.48
United Facility/Professional Facility Modifier Low / Median / High Price $0.46 / $28.82 / $29.08	Facility		$0.46	$28.82	$29.08
United Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $29.13 / $55.48	Professional		$26.89	$29.13	$55.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $31.22 / $34.78	Professional		$31.22	$31.22	$34.78