Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.25 / $159.47 / $254.10	Facility		$70.25	$159.47	$254.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $70.25 / $166.49	Professional		$56.10	$70.25	$166.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $105.58 / $224.84 / $475.86	Facility		$105.58	$224.84	$475.86
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $109.56 / $791.85	Professional		$78.92	$109.56	$791.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.96 / $87.96 / $87.96	Facility		$87.96	$87.96	$87.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.77 / $74.77 / $87.96	Professional		$74.77	$74.77	$87.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $65.76 / $112.29 / $296.23	Facility		$65.76	$112.29	$296.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.13 / $113.55 / $209.35	Professional		$69.13	$113.55	$209.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.69 / $101.88 / $114.76	Professional		$91.69	$101.88	$114.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.30 / $108.11 / $113.52	Facility		$97.30	$108.11	$113.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $85.88 / $85.88 / $85.88	Professional		$85.88	$85.88	$85.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.97 / $188.99 / $267.54	Facility		$131.97	$188.99	$267.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.47 / $108.05 / $190.37	Professional		$95.47	$108.05	$190.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $102.90 / $105.58 / $105.58	Facility		$102.90	$105.58	$105.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $118.92 / $118.92	Professional		$78.92	$118.92	$118.92
United Facility/Professional Professional Modifier Low / Median / High Price $49.38 / $74.06 / $94.21	Professional		$49.38	$74.06	$94.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.29 / $91.89 / $91.89	Professional		$87.29	$91.89	$91.89