Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.59 / $146.63 / $209.56	Facility		$64.59	$146.63	$209.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.51 / $64.59 / $153.10	Professional		$55.51	$64.59	$153.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $83.82 / $199.12 / $456.72	Facility		$83.82	$199.12	$456.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $68.16 / $83.28 / $493.67	Professional		$68.16	$83.28	$493.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.58 / $66.58 / $66.58	Facility		$66.58	$66.58	$66.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.60 / $48.60 / $66.58	Professional		$48.60	$48.60	$66.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $49.61 / $95.72 / $251.25	Facility		$49.61	$95.72	$251.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.77 / $95.72 / $186.18	Professional		$51.77	$95.72	$186.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.18 / $90.21 / $101.60	Professional		$81.18	$90.21	$101.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.98 / $93.48 / $99.13	Facility		$75.98	$93.48	$99.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $86.15 / $95.72 / $99.13	Professional		$86.15	$95.72	$99.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.82 / $107.50 / $186.96	Facility		$83.82	$107.50	$186.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.45 / $79.45 / $93.48	Professional		$79.45	$79.45	$93.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $91.11 / $93.48 / $93.48	Facility		$91.11	$93.48	$93.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $76.04 / $81.36 / $105.29	Professional		$76.04	$81.36	$105.29
United Facility/Professional Professional Modifier Low / Median / High Price $40.42 / $47.15 / $83.39	Professional		$40.42	$47.15	$83.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $37.99 / $81.36	Professional		$37.99	$37.99	$81.36