Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.38 / $134.79 / $140.72	Facility		$59.38	$134.79	$140.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.27 / $59.38 / $140.72	Professional		$49.27	$59.38	$140.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $77.05 / $221.38 / $473.76	Facility		$77.05	$221.38	$473.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $64.23 / $77.05 / $700.07	Professional		$64.23	$77.05	$700.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.90 / $65.90 / $65.90	Facility		$65.90	$65.90	$65.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.11 / $48.11 / $65.90	Professional		$48.11	$48.11	$65.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $55.51 / $93.81 / $241.12	Facility		$55.51	$93.81	$241.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $94.50 / $187.01	Professional		$55.57	$94.50	$187.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.70 / $67.45 / $74.19	Professional		$60.70	$67.45	$74.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.84 / $85.93 / $87.99	Facility		$69.84	$85.93	$87.99
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $69.90 / $87.99 / $87.99	Professional		$69.90	$87.99	$87.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.05 / $98.82 / $171.86	Facility		$77.05	$98.82	$171.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.04 / $73.04 / $73.04	Professional		$73.04	$73.04	$73.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $83.75 / $85.93 / $85.93	Facility		$83.75	$85.93	$85.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.90 / $74.79 / $96.79	Professional		$69.90	$74.79	$96.79
United Facility/Professional Professional Modifier Low / Median / High Price $40.59 / $43.97 / $83.75	Professional		$40.59	$43.97	$83.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.53 / $51.53 / $53.40	Professional		$51.53	$51.53	$53.40