Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.61 / $155.75 / $162.61	Facility		$68.61	$155.75	$162.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $68.61 / $162.61	Professional		$42.70	$68.61	$162.61
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $89.02 / $193.60 / $395.32	Facility		$89.02	$193.60	$395.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $58.82 / $86.41 / $503.22	Professional		$58.82	$86.41	$503.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.11 / $54.11 / $54.11	Facility		$54.11	$54.11	$54.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $39.50 / $54.11	Professional		$39.50	$39.50	$54.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.77 / $96.58 / $218.43	Facility		$47.77	$96.58	$218.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.82 / $96.58 / $162.19	Professional		$47.82	$96.58	$162.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.13 / $77.93 / $85.72	Professional		$70.13	$77.93	$85.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.45 / $99.28 / $101.66	Facility		$74.45	$99.28	$101.66
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $80.76 / $80.76 / $80.76	Professional		$80.76	$80.76	$80.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.02 / $114.17 / $198.56	Facility		$89.02	$114.17	$198.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.39 / $84.39 / $84.39	Professional		$84.39	$84.39	$84.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $96.76 / $99.28 / $99.28	Facility		$96.76	$99.28	$99.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $80.76 / $86.41 / $111.83	Professional		$80.76	$86.41	$111.83
United Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $48.00 / $48.00	Facility		$48.00	$48.00	$48.00
United Facility/Professional Professional Modifier Low / Median / High Price $35.17 / $38.10 / $72.56	Professional		$35.17	$38.10	$72.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $42.98 / $46.18	Professional		$42.98	$42.98	$46.18