Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.18 / $107.10 / $111.82	Facility		$47.18	$107.10	$111.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.94 / $47.18 / $111.82	Professional		$41.94	$47.18	$111.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $61.22 / $201.94 / $365.88	Facility		$61.22	$201.94	$365.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $51.04 / $61.22 / $638.46	Professional		$51.04	$61.22	$638.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.77 / $42.77 / $42.77	Facility		$42.77	$42.77	$42.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $31.22 / $42.77	Professional		$31.22	$31.22	$42.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $43.22 / $73.41 / $191.55	Facility		$43.22	$73.41	$191.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.27 / $73.41 / $144.81	Professional		$43.27	$73.41	$144.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.23 / $53.59 / $58.94	Professional		$48.23	$53.59	$58.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $55.49 / $68.28 / $91.27	Facility		$55.49	$68.28	$91.27
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $62.93 / $69.92 / $91.27	Professional		$62.93	$69.92	$91.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.22 / $78.52 / $136.56	Facility		$61.22	$78.52	$136.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.04 / $58.04 / $58.04	Professional		$58.04	$58.04	$58.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $66.55 / $68.28 / $68.28	Facility		$66.55	$68.28	$68.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $55.53 / $59.43 / $76.91	Professional		$55.53	$59.43	$76.91
United Facility/Professional Facility Modifier Low / Median / High Price $26.31 / $33.85 / $43.72	Facility		$26.31	$33.85	$43.72
United Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $34.20 / $65.15	Professional		$31.57	$34.20	$65.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $29.14 / $41.54	Professional		$29.14	$29.14	$41.54