Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.52 / $132.84 / $138.69	Facility		$58.52	$132.84	$138.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.60 / $58.52 / $150.00	Professional		$49.60	$58.52	$150.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $75.93 / $180.41 / $413.81	Facility		$75.93	$180.41	$413.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $61.76 / $75.45 / $447.50	Professional		$61.76	$75.45	$447.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.02 / $56.02 / $56.02	Facility		$56.02	$56.02	$56.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $40.89 / $56.25	Professional		$40.89	$40.89	$56.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.10 / $91.86 / $227.81	Facility		$50.10	$91.86	$227.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $91.65 / $168.81	Professional		$51.33	$91.65	$168.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $86.72 / $86.72	Professional		$60.00	$86.72	$86.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.84 / $84.69 / $89.86	Facility		$68.84	$84.69	$89.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $78.05 / $86.72 / $89.86	Professional		$78.05	$86.72	$89.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.93 / $97.39 / $169.38	Facility		$75.93	$97.39	$169.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.98 / $71.98 / $84.69	Professional		$71.98	$71.98	$84.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $82.54 / $84.69 / $84.69	Facility		$82.54	$84.69	$84.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $68.90 / $73.70 / $95.39	Professional		$68.90	$73.70	$95.39
United Facility/Professional Professional Modifier Low / Median / High Price $37.28 / $42.72 / $75.56	Professional		$37.28	$42.72	$75.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $73.70 / $83.26 / $83.26	Professional		$73.70	$83.26	$83.26