Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.42 / $105.37 / $110.02	Facility		$46.42	$105.37	$110.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.90 / $46.42 / $80.31	Professional		$34.90	$46.42	$80.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $60.23 / $143.18 / $328.21	Facility		$60.23	$143.18	$328.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.99 / $59.84 / $354.92	Professional		$48.99	$59.84	$354.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.35 / $39.35 / $39.35	Facility		$39.35	$39.35	$39.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.73 / $28.73 / $39.35	Professional		$28.73	$28.73	$39.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.97 / $68.78 / $180.00	Facility		$26.97	$68.78	$180.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.97 / $68.78 / $134.05	Professional		$26.97	$68.78	$134.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $68.78 / $68.78	Professional		$60.00	$68.78	$68.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $54.63 / $67.17 / $71.27	Facility		$54.63	$67.17	$71.27
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $54.66 / $68.78 / $71.27	Professional		$54.66	$68.78	$71.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.23 / $77.25 / $134.34	Facility		$60.23	$77.25	$134.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.09 / $57.09 / $67.17	Professional		$57.09	$57.09	$67.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $65.47 / $67.17 / $67.17	Facility		$65.47	$67.17	$67.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.66 / $58.46 / $75.66	Professional		$54.66	$58.46	$75.66
United Facility/Professional Professional Modifier Low / Median / High Price $29.05 / $31.47 / $59.94	Professional		$29.05	$31.47	$59.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $11.97 / $11.97 / $58.46	Professional		$11.97	$11.97	$58.46