Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.52 / $61.52 / $144.76	Facility		$61.52	$61.52	$144.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $61.52 / $61.52	Professional		$57.90	$61.52	$61.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $60.31 / $111.36 / $271.43	Facility		$60.31	$111.36	$271.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $60.31 / $60.31 / $477.55	Professional		$60.31	$60.31	$477.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.52 / $61.52 / $404.96	Facility		$61.52	$61.52	$404.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $61.52 / $61.52	Professional		$61.52	$61.52	$61.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.76 / $99.47 / $156.13	Facility		$60.76	$99.47	$156.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.76 / $99.47 / $156.13	Professional		$60.76	$99.47	$156.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $70.00 / $79.81	Professional		$30.00	$70.00	$79.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $111.31 / $79,999.20 / $79,999.20	Facility		$111.31	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.08 / $60.08 / $61.52	Facility		$60.08	$60.08	$61.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.73 / $65.14 / $72.38	Professional		$55.73	$65.14	$72.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $60.31 / $60.31 / $60.31	Facility		$60.31	$60.31	$60.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.29 / $60.31 / $60.31	Professional		$57.29	$60.31	$60.31
United Facility/Professional Professional Modifier Low / Median / High Price $60.32 / $60.32 / $68.76	Professional		$60.32	$60.32	$68.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.32 / $60.32 / $60.32	Professional		$60.32	$60.32	$60.32