Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.66 / $169.48 / $176.94	Facility		$74.66	$169.48	$176.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.73 / $74.66 / $176.94	Professional		$52.73	$74.66	$176.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $96.87 / $210.68 / $476.85	Facility		$96.87	$210.68	$476.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $94.04 / $612.91	Professional		$72.09	$94.04	$612.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.84 / $58.84 / $58.84	Facility		$58.84	$58.84	$58.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $42.95 / $58.84	Professional		$42.95	$42.95	$58.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $59.15 / $110.63 / $269.06	Facility		$59.15	$110.63	$269.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.21 / $108.45 / $200.25	Professional		$59.21	$108.45	$200.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.32 / $84.81 / $93.29	Professional		$76.32	$84.81	$93.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.95 / $108.04 / $110.63	Facility		$91.95	$108.04	$110.63
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $87.89 / $87.89 / $110.63	Professional		$87.89	$87.89	$110.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $96.87 / $124.25 / $216.08	Facility		$96.87	$124.25	$216.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.27 / $91.83 / $91.83	Professional		$83.27	$91.83	$91.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $105.30 / $108.04 / $108.04	Facility		$105.30	$108.04	$108.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $87.89 / $94.04 / $121.69	Professional		$87.89	$94.04	$121.69
United Facility/Professional Professional Modifier Low / Median / High Price $43.43 / $46.98 / $89.62	Professional		$43.43	$46.98	$89.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $57.19	Professional		$50.00	$50.00	$57.19