Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.69 / $126.42 / $131.99	Facility		$55.69	$126.42	$131.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.01 / $55.69 / $126.42	Professional		$26.01	$55.69	$126.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $75.04 / $163.19 / $410.39	Facility		$75.04	$163.19	$410.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.95 / $86.68 / $627.67	Professional		$48.95	$86.68	$627.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.70 / $69.70 / $69.70	Facility		$69.70	$69.70	$69.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $59.25 / $69.70	Professional		$59.25	$59.25	$69.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $49.14 / $85.70 / $224.06	Facility		$49.14	$85.70	$224.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.19 / $86.36 / $167.15	Professional		$49.19	$86.36	$167.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.68 / $82.70 / $90.97	Professional		$72.68	$82.70	$90.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $77.13 / $85.70 / $88.76	Facility		$77.13	$85.70	$88.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.04 / $96.24 / $167.38	Facility		$75.04	$96.24	$167.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.14 / $71.14 / $83.69	Professional		$71.14	$71.14	$83.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $81.56 / $83.69 / $83.69	Facility		$81.56	$83.69	$83.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $62.56 / $94.27 / $94.27	Professional		$62.56	$94.27	$94.27
United Facility/Professional Professional Modifier Low / Median / High Price $39.13 / $60.30 / $74.66	Professional		$39.13	$60.30	$74.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $72.84 / $72.84	Professional		$47.52	$72.84	$72.84