Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.53 / $112.43 / $384.32	Facility		$49.53	$112.43	$384.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.56 / $49.53 / $117.39	Professional		$39.56	$49.53	$117.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $74.44 / $158.52 / $335.46	Facility		$74.44	$158.52	$335.46
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $54.29 / $83.85 / $558.29	Professional		$54.29	$83.85	$558.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.01 / $62.01 / $62.01	Facility		$62.01	$62.01	$62.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.71 / $52.71 / $62.01	Professional		$52.71	$52.71	$62.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $46.08 / $78.69 / $208.85	Facility		$46.08	$78.69	$208.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $80.45 / $148.12	Professional		$48.98	$80.45	$148.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.64 / $71.83 / $80.91	Professional		$64.64	$71.83	$80.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.61 / $76.23 / $83.85	Facility		$68.61	$76.23	$83.85
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $60.54 / $60.54 / $60.54	Professional		$60.54	$60.54	$60.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.05 / $133.25 / $188.63	Facility		$93.05	$133.25	$188.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $76.18 / $134.22	Professional		$67.31	$76.18	$134.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.55 / $74.44 / $74.44	Facility		$72.55	$74.44	$74.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $83.85 / $83.85	Professional		$55.65	$83.85	$83.85
United Facility/Professional Facility Modifier Low / Median / High Price $26.82 / $46.00 / $53.64	Facility		$26.82	$46.00	$53.64
United Facility/Professional Professional Modifier Low / Median / High Price $34.81 / $50.93 / $66.42	Professional		$34.81	$50.93	$66.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.80 / $64.80 / $118.75	Professional		$64.80	$64.80	$118.75