Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.65 / $153.57 / $160.33	Facility		$67.65	$153.57	$160.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.82 / $67.65 / $117.04	Professional		$50.82	$67.65	$117.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $87.78 / $208.46 / $478.20	Facility		$87.78	$208.46	$478.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $87.22 / $516.82	Professional		$71.37	$87.22	$516.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.32 / $57.32 / $57.32	Facility		$57.32	$57.32	$57.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $41.84 / $65.01	Professional		$41.84	$41.84	$65.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.64 / $100.25 / $262.50	Facility		$40.64	$100.25	$262.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $100.25 / $194.46	Professional		$41.40	$100.25	$194.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.02 / $94.47 / $106.41	Professional		$85.02	$94.47	$106.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.55 / $97.90 / $103.78	Facility		$79.55	$97.90	$103.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $95.24 / $100.25 / $103.78	Professional		$95.24	$100.25	$103.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.78 / $112.59 / $195.80	Facility		$87.78	$112.59	$195.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.22 / $83.22 / $97.90	Professional		$83.22	$83.22	$97.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.42 / $97.90 / $97.90	Facility		$95.42	$97.90	$97.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.63 / $85.21 / $110.28	Professional		$79.63	$85.21	$110.28
United Facility/Professional Facility Modifier Low / Median / High Price $122.32 / $146.78 / $146.78	Facility		$122.32	$146.78	$146.78
United Facility/Professional Professional Modifier Low / Median / High Price $42.31 / $45.84 / $87.32	Professional		$42.31	$45.84	$87.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.53 / $51.53 / $85.21	Professional		$51.53	$51.53	$85.21