Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.43 / $116.75 / $121.89	Facility		$51.43	$116.75	$121.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $51.43 / $121.89	Professional		$45.71	$51.43	$121.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $66.73 / $180.51 / $416.19	Facility		$66.73	$180.51	$416.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $55.63 / $68.02 / $567.17	Professional		$55.63	$68.02	$567.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.54 / $54.54 / $54.54	Facility		$54.54	$54.54	$54.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $54.54	Professional		$39.81	$39.81	$54.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.77 / $80.93 / $208.82	Facility		$47.77	$80.93	$208.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.82 / $81.84 / $162.19	Professional		$47.82	$81.84	$162.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $76.20 / $76.20	Professional		$60.00	$76.20	$76.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $60.50 / $74.42 / $91.93	Facility		$60.50	$74.42	$91.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $76.20 / $91.93	Professional		$68.59	$76.20	$91.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.73 / $85.58 / $148.84	Facility		$66.73	$85.58	$148.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $63.26 / $63.26	Professional		$63.26	$63.26	$63.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.54 / $74.42 / $74.42	Facility		$72.54	$74.42	$74.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.54 / $64.78 / $83.83	Professional		$60.54	$64.78	$83.83
United Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $38.08 / $72.54	Professional		$35.15	$38.08	$72.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.68 / $64.78 / $64.78	Professional		$45.68	$64.78	$64.78