Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $116.43 / $121.56	Facility		$51.29	$116.43	$121.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.99 / $51.29 / $51.29	Professional		$28.99	$51.29	$51.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $65.27 / $269.04 / $269.04	Facility		$65.27	$269.04	$269.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.60 / $63.87 / $442.50	Professional		$48.60	$63.87	$442.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.68 / $49.68 / $49.68	Facility		$49.68	$49.68	$49.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.27 / $36.27 / $49.68	Professional		$36.27	$36.27	$49.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.74 / $107.41 / $173.05	Facility		$47.74	$107.41	$173.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.74 / $101.30 / $138.71	Professional		$47.74	$101.30	$138.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $59.80 / $92.47 / $101.84	Facility		$59.80	$92.47	$101.84
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $59.80 / $59.80 / $59.80	Professional		$59.80	$59.80	$59.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.45 / $69.45 / $69.45	Professional		$69.45	$69.45	$69.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $63.25 / $75.90 / $138.66	Facility		$63.25	$75.90	$138.66
United Facility/Professional Professional Modifier Low / Median / High Price $31.64 / $36.22 / $54.86	Professional		$31.64	$36.22	$54.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.79 / $49.79 / $49.79	Professional		$49.79	$49.79	$49.79