Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.45 / $159.94 / $166.99	Facility		$70.45	$159.94	$166.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.75 / $69.59 / $166.99	Professional		$51.75	$69.59	$166.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $91.43 / $188.63 / $456.49	Facility		$91.43	$188.63	$456.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $71.98 / $91.43 / $551.57	Professional		$71.98	$91.43	$551.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.85 / $53.85 / $53.85	Facility		$53.85	$53.85	$53.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.31 / $39.31 / $80.54	Professional		$39.31	$39.31	$80.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.12 / $104.41 / $286.12	Facility		$57.12	$104.41	$286.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.45 / $104.41 / $182.87	Professional		$60.45	$104.41	$182.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.04 / $80.05 / $88.05	Professional		$72.04	$80.05	$88.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $82.88 / $93.97 / $104.41	Facility		$82.88	$93.97	$104.41
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $86.18 / $99.19 / $104.41	Professional		$86.18	$99.19	$104.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.67 / $91.43 / $198.82	Facility		$86.67	$91.43	$198.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.67 / $98.90 / $150.06	Professional		$86.67	$98.90	$150.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $99.38 / $101.96 / $101.96	Facility		$99.38	$101.96	$101.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $82.95 / $88.75 / $114.85	Professional		$82.95	$88.75	$114.85
United Facility/Professional Professional Modifier Low / Median / High Price $40.09 / $43.06 / $82.03	Professional		$40.09	$43.06	$82.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.02 / $57.02 / $88.75	Professional		$57.02	$57.02	$88.75