Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.40 / $125.76 / $131.30	Facility		$55.40	$125.76	$131.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.01 / $55.40 / $131.30	Professional		$42.01	$55.40	$131.30
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $74.65 / $168.96 / $445.11	Facility		$74.65	$168.96	$445.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $78.41 / $554.50	Professional		$62.23	$78.41	$554.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.87 / $59.87 / $59.87	Facility		$59.87	$59.87	$59.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.71 / $43.71 / $59.87	Professional		$43.71	$43.71	$59.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $52.78 / $90.28 / $233.64	Facility		$52.78	$90.28	$233.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.83 / $90.28 / $177.91	Professional		$52.83	$90.28	$177.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.82 / $65.36 / $71.89	Professional		$58.82	$65.36	$71.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.69 / $83.25 / $85.25	Facility		$67.69	$83.25	$85.25
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $80.98 / $85.25 / $85.25	Professional		$80.98	$85.25	$85.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.65 / $95.74 / $166.50	Facility		$74.65	$95.74	$166.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $70.76 / $70.76	Professional		$70.76	$70.76	$70.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $81.14 / $83.25 / $83.25	Facility		$81.14	$83.25	$83.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $72.45 / $93.78	Professional		$67.73	$72.45	$93.78
United Facility/Professional Professional Modifier Low / Median / High Price $41.92 / $62.87 / $79.97	Professional		$41.92	$62.87	$79.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $31.22 / $50.99	Professional		$31.22	$31.22	$50.99