Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.48 / $116.86 / $122.01	Facility		$51.48	$116.86	$122.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.23 / $51.48 / $122.01	Professional		$44.23	$51.48	$122.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $66.79 / $158.62 / $363.92	Facility		$66.79	$158.62	$363.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $54.31 / $66.36 / $393.37	Professional		$54.31	$66.36	$393.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.62 / $43.62 / $43.62	Facility		$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $31.84 / $43.62	Professional		$31.84	$31.84	$43.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $44.18 / $77.59 / $200.62	Facility		$44.18	$77.59	$200.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.18 / $77.81 / $148.12	Professional		$44.18	$77.81	$148.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $76.28 / $76.28	Professional		$60.00	$76.28	$76.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $60.54 / $74.48 / $78.98	Facility		$60.54	$74.48	$78.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $68.65 / $76.28 / $78.98	Professional		$68.65	$76.28	$78.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.79 / $85.66 / $148.97	Facility		$66.79	$85.66	$148.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.32 / $63.32 / $74.48	Professional		$63.32	$63.32	$74.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.59 / $74.48 / $74.48	Facility		$72.59	$74.48	$74.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $64.84 / $83.91	Professional		$60.59	$64.84	$83.91
United Facility/Professional Professional Modifier Low / Median / High Price $32.20 / $34.83 / $66.45	Professional		$32.20	$34.83	$66.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.15 / $36.15 / $64.84	Professional		$36.15	$36.15	$64.84