Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.66 / $160.40 / $167.46	Facility		$70.66	$160.40	$167.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.73 / $70.66 / $167.46	Professional		$60.73	$70.66	$167.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $91.69 / $199.41 / $499.54	Facility		$91.69	$199.41	$499.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $73.30 / $90.05 / $540.03	Professional		$73.30	$90.05	$540.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.89 / $59.89 / $59.89	Facility		$59.89	$59.89	$59.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.72 / $43.72 / $59.89	Professional		$43.72	$43.72	$59.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.20 / $104.71 / $273.75	Facility		$57.20	$104.71	$273.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.95 / $104.71 / $202.73	Professional		$59.95	$104.71	$202.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.81 / $98.68 / $111.15	Professional		$88.81	$98.68	$111.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $83.11 / $102.26 / $108.44	Facility		$83.11	$102.26	$108.44
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $94.24 / $104.71 / $108.44	Professional		$94.24	$104.71	$108.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.69 / $117.60 / $204.52	Facility		$91.69	$117.60	$204.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.92 / $86.92 / $86.92	Professional		$86.92	$86.92	$86.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $99.67 / $102.26 / $102.26	Facility		$99.67	$102.26	$102.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $89.00 / $115.18	Professional		$83.18	$89.00	$115.18
United Facility/Professional Professional Modifier Low / Median / High Price $44.20 / $47.89 / $91.22	Professional		$44.20	$47.89	$91.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $37.99 / $89.00	Professional		$37.99	$37.99	$89.00