Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.75 / $137.90 / $143.97	Facility		$60.75	$137.90	$143.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.93 / $60.75 / $143.97	Professional		$38.93	$60.75	$143.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $81.84 / $168.87 / $404.35	Facility		$81.84	$168.87	$404.35
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $59.61 / $79.45 / $490.30	Professional		$59.61	$79.45	$490.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.36 / $50.36 / $50.36	Facility		$50.36	$50.36	$50.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.76 / $36.76 / $50.36	Professional		$36.76	$36.76	$50.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $49.14 / $93.36 / $223.12	Facility		$49.14	$93.36	$223.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.19 / $89.61 / $164.67	Professional		$49.19	$89.61	$164.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.49 / $71.66 / $78.82	Professional		$64.49	$71.66	$78.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.20 / $84.12 / $93.47	Facility		$74.20	$84.12	$93.47
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $93.47 / $102.82	Professional		$77.84	$93.47	$102.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.84 / $104.97 / $182.56	Facility		$81.84	$104.97	$182.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.64 / $77.59 / $77.59	Professional		$73.64	$77.59	$77.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $88.97 / $91.28 / $91.28	Facility		$88.97	$91.28	$91.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.26 / $79.45 / $102.82	Professional		$74.26	$79.45	$102.82
United Facility/Professional Professional Modifier Low / Median / High Price $38.84 / $58.50 / $74.09	Professional		$38.84	$58.50	$74.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $46.84 / $79.45	Professional		$46.84	$46.84	$79.45