Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.57 / $137.49 / $143.55	Facility		$60.57	$137.49	$143.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.04 / $60.57 / $143.55	Professional		$52.04	$60.57	$143.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $78.59 / $186.62 / $428.17	Facility		$78.59	$186.62	$428.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $63.91 / $78.08 / $462.74	Professional		$63.91	$78.08	$462.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.32 / $51.32 / $51.32	Facility		$51.32	$51.32	$51.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.46 / $37.46 / $51.32	Professional		$37.46	$37.46	$51.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $51.92 / $94.34 / $235.31	Facility		$51.92	$94.34	$235.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.92 / $94.34 / $174.60	Professional		$51.92	$94.34	$174.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.92 / $68.80 / $75.68	Professional		$61.92	$68.80	$75.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $71.25 / $87.65 / $92.92	Facility		$71.25	$87.65	$92.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $92.92	Professional		$89.75	$89.75	$92.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.59 / $100.80 / $175.30	Facility		$78.59	$100.80	$175.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.50 / $74.50 / $87.65	Professional		$74.50	$74.50	$87.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $85.43 / $87.65 / $87.65	Facility		$85.43	$87.65	$87.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $71.30 / $76.29 / $98.73	Professional		$71.30	$76.29	$98.73
United Facility/Professional Professional Modifier Low / Median / High Price $37.89 / $44.21 / $78.18	Professional		$37.89	$44.21	$78.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.35 / $34.35 / $76.29	Professional		$34.35	$34.35	$76.29