Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.43 / $123.56 / $129.00	Facility		$54.43	$123.56	$129.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $54.43 / $129.00	Professional		$36.65	$54.43	$129.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $73.34 / $182.33 / $392.56	Facility		$73.34	$182.33	$392.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $56.71 / $72.86 / $576.36	Professional		$56.71	$72.86	$576.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.81 / $45.81 / $45.81	Facility		$45.81	$45.81	$45.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.44 / $33.44 / $45.81	Professional		$33.44	$33.44	$45.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $45.95 / $83.75 / $210.93	Facility		$45.95	$83.75	$210.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $83.75 / $155.57	Professional		$46.00	$83.75	$155.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.79 / $64.22 / $70.64	Professional		$57.79	$64.22	$70.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $66.50 / $75.38 / $83.75	Facility		$66.50	$75.38	$83.75
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $73.31 / $80.65 / $85.43	Professional		$73.31	$80.65	$85.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.34 / $94.06 / $163.58	Facility		$73.34	$94.06	$163.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.52 / $69.52 / $69.52	Professional		$69.52	$69.52	$69.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $79.72 / $81.79 / $81.79	Facility		$79.72	$81.79	$81.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.55 / $71.19 / $92.13	Professional		$66.55	$71.19	$92.13
United Facility/Professional Professional Modifier Low / Median / High Price $36.58 / $55.04 / $69.79	Professional		$36.58	$55.04	$69.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $37.47 / $44.58	Professional		$37.47	$37.47	$44.58