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 $58.12 / $67.65 / $160.33	Professional		$58.12	$67.65	$160.33
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 $69.65 / $69.65 / $69.65	Facility		$69.65	$69.65	$69.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.84 / $50.84 / $69.65	Professional		$50.84	$50.84	$69.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $39.36 / $100.25 / $262.50	Facility		$39.36	$100.25	$262.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $100.25 / $194.46	Professional		$39.36	$100.25	$194.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $100.25 / $100.25	Professional		$60.00	$100.25	$100.25
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 $100.25 / $100.25 / $103.78	Professional		$100.25	$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 Professional Modifier Low / Median / High Price $42.31 / $52.89 / $87.32	Professional		$42.31	$52.89	$87.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.86 / $21.86 / $85.21	Professional		$21.86	$21.86	$85.21