Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.20 / $163.89 / $171.11	Facility		$72.20	$163.89	$171.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.55 / $72.20 / $171.11	Professional		$57.55	$72.20	$171.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $97.28 / $211.56 / $532.02	Facility		$97.28	$211.56	$532.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $66.65 / $112.39 / $813.68	Professional		$66.65	$112.39	$813.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.38 / $90.38 / $90.38	Facility		$90.38	$90.38	$90.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.81 / $76.81 / $90.38	Professional		$76.81	$76.81	$90.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.15 / $111.09 / $290.62	Facility		$64.15	$111.09	$290.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.22 / $112.75 / $215.97	Professional		$64.22	$112.75	$215.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $111.09 / $111.09	Professional		$60.00	$111.09	$111.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.98 / $111.09 / $115.09	Facility		$99.98	$111.09	$115.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $88.26 / $88.26 / $88.26	Professional		$88.26	$88.26	$88.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.28 / $124.76 / $216.98	Facility		$97.28	$124.76	$216.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.22 / $92.22 / $92.22	Professional		$92.22	$92.22	$92.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $105.74 / $108.49 / $108.49	Facility		$105.74	$108.49	$108.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.09 / $122.20 / $122.20	Professional		$81.09	$122.20	$122.20
United Facility/Professional Professional Modifier Low / Median / High Price $50.74 / $74.23 / $96.79	Professional		$50.74	$74.23	$96.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.08 / $94.43 / $94.43	Professional		$61.08	$94.43	$94.43