Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.97 / $195.15 / $203.75	Facility		$85.97	$195.15	$203.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.21 / $85.97 / $203.75	Professional		$54.21	$85.97	$203.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $111.54 / $242.58 / $510.12	Facility		$111.54	$242.58	$510.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $108.27 / $677.70	Professional		$73.81	$108.27	$677.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.81 / $61.81 / $61.81	Facility		$61.81	$61.81	$61.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.12 / $45.12 / $61.81	Professional		$45.12	$45.12	$61.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.06 / $121.01 / $273.75	Facility		$60.06	$121.01	$273.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.12 / $121.01 / $202.73	Professional		$60.12	$121.01	$202.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.88 / $97.65 / $107.41	Professional		$87.88	$97.65	$107.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $94.53 / $109.67 / $127.38	Facility		$94.53	$109.67	$127.38
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $96.80 / $114.64 / $127.38	Professional		$96.80	$114.64	$127.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.54 / $143.06 / $248.80	Facility		$111.54	$143.06	$248.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $121.24 / $124.40 / $124.40	Facility		$121.24	$124.40	$124.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $101.19 / $108.27 / $140.12	Professional		$101.19	$108.27	$140.12
United Facility/Professional Professional Modifier Low / Median / High Price $44.86 / $51.41 / $90.93	Professional		$44.86	$51.41	$90.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $35.39 / $108.27	Professional		$35.39	$35.39	$108.27