Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.05 / $113.61 / $118.62	Facility		$50.05	$113.61	$118.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $50.05 / $118.62	Professional		$29.46	$50.05	$118.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $67.45 / $178.80 / $305.37	Facility		$67.45	$178.80	$305.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $44.40 / $65.48 / $565.29	Professional		$44.40	$65.48	$565.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.36 / $37.36 / $37.36	Facility		$37.36	$37.36	$37.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $27.27 / $37.36	Professional		$27.27	$27.27	$37.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.40 / $73.18 / $165.00	Facility		$36.40	$73.18	$165.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $73.18 / $122.47	Professional		$36.44	$73.18	$122.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.14 / $59.05 / $64.95	Professional		$53.14	$59.05	$64.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.53 / $64.80 / $77.03	Facility		$57.53	$64.80	$77.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $77.03 / $77.03	Professional		$58.91	$77.03	$77.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.45 / $86.50 / $150.44	Facility		$67.45	$86.50	$150.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.94 / $63.94 / $63.94	Professional		$63.94	$63.94	$63.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $73.31 / $75.22 / $75.22	Facility		$73.31	$75.22	$75.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.19 / $65.48 / $84.73	Professional		$61.19	$65.48	$84.73
United Facility/Professional Professional Modifier Low / Median / High Price $28.82 / $43.23 / $54.99	Professional		$28.82	$43.23	$54.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.61 / $15.61 / $35.13	Professional		$15.61	$15.61	$35.13