Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.42 / $36.20 / $181.78	Facility		$31.42	$36.20	$181.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.91 / $68.66 / $118.88	Professional		$48.91	$68.66	$118.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $103.91 / $225.99 / $501.46	Facility		$103.91	$225.99	$501.46
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $73.98 / $100.87 / $706.59	Professional		$73.98	$100.87	$706.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.69 / $62.81 / $62.81	Facility		$56.69	$62.81	$62.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $45.85 / $62.81	Professional		$45.85	$45.85	$62.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.06 / $114.58 / $273.75	Facility		$60.06	$114.58	$273.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.12 / $112.74 / $202.73	Professional		$60.12	$112.74	$202.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.87 / $90.97 / $100.06	Professional		$81.87	$90.97	$100.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $93.49 / $105.30 / $118.67	Facility		$93.49	$105.30	$118.67
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $94.27 / $105.30 / $118.67	Professional		$94.27	$105.30	$118.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $103.91 / $133.27 / $231.78	Facility		$103.91	$133.27	$231.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.51 / $98.51 / $98.51	Professional		$98.51	$98.51	$98.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $112.95 / $115.89 / $115.89	Facility		$112.95	$115.89	$115.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $94.27 / $100.87 / $130.54	Professional		$94.27	$100.87	$130.54
United Facility/Professional Professional Modifier Low / Median / High Price $44.15 / $51.51 / $91.12	Professional		$44.15	$51.51	$91.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.51 / $38.51 / $57.96	Professional		$38.51	$38.51	$57.96