Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.73 / $112.89 / $117.86	Facility		$49.73	$112.89	$117.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $49.73 / $117.86	Professional		$36.22	$49.73	$117.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $67.00 / $141.04 / $328.96	Facility		$67.00	$141.04	$328.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $65.03 / $392.45	Professional		$48.90	$65.03	$392.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.94 / $44.94 / $44.94	Facility		$44.94	$44.94	$44.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.81 / $32.81 / $44.94	Professional		$32.81	$32.81	$44.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.67 / $73.73 / $175.31	Facility		$38.67	$73.73	$175.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.71 / $72.68 / $129.91	Professional		$38.71	$72.68	$129.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.78 / $58.65 / $64.51	Professional		$52.78	$58.65	$64.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $60.74 / $72.44 / $76.51	Facility		$60.74	$72.44	$76.51
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $60.78 / $76.51 / $79.68	Professional		$60.78	$76.51	$79.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.00 / $85.93 / $149.44	Facility		$67.00	$85.93	$149.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.51 / $63.51 / $73.18	Professional		$63.51	$63.51	$73.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.83 / $74.72 / $74.72	Facility		$72.83	$74.72	$74.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.78 / $65.03 / $84.16	Professional		$60.78	$65.03	$84.16
United Facility/Professional Facility Modifier Low / Median / High Price $37.24 / $37.24 / $37.24	Facility		$37.24	$37.24	$37.24
United Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $45.88 / $58.36	Professional		$30.59	$45.88	$58.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $10.41 / $10.41 / $39.13	Professional		$10.41	$10.41	$39.13