Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.67 / $167.23 / $174.60	Facility		$73.67	$167.23	$174.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.35 / $73.67 / $174.60	Professional		$63.35	$73.67	$174.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $95.59 / $227.06 / $520.92	Facility		$95.59	$227.06	$520.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $77.75 / $94.98 / $563.39	Professional		$77.75	$94.98	$563.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.72 / $66.72 / $66.72	Facility		$66.72	$66.72	$66.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.71 / $48.71 / $66.72	Professional		$48.71	$48.71	$66.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $62.85 / $115.64 / $285.93	Facility		$62.85	$115.64	$285.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.68 / $115.07 / $212.66	Professional		$65.68	$115.07	$212.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $92.59 / $102.88 / $115.88	Professional		$92.59	$102.88	$115.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.66 / $106.61 / $113.13	Facility		$86.66	$106.61	$113.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $92.79 / $109.17 / $113.13	Professional		$92.79	$109.17	$113.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.59 / $122.60 / $213.22	Facility		$95.59	$122.60	$213.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.62 / $90.62 / $90.62	Professional		$90.62	$90.62	$90.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $103.91 / $106.61 / $106.61	Facility		$103.91	$106.61	$106.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $86.73 / $92.79 / $120.09	Professional		$86.73	$92.79	$120.09
United Facility/Professional Professional Modifier Low / Median / High Price $46.10 / $58.16 / $95.12	Professional		$46.10	$58.16	$95.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $11.97 / $11.97 / $92.79	Professional		$11.97	$11.97	$92.79