Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.96 / $85.96 / $85.96	Facility		$85.96	$85.96	$85.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $85.96 / $85.96	Professional		$80.90	$85.96	$85.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $83.94 / $112.07 / $379.24	Facility		$83.94	$112.07	$379.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $85.95 / $844.00 / $844.00	Professional		$85.95	$844.00	$844.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.96 / $85.96 / $349.96	Facility		$85.96	$85.96	$349.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.96 / $85.96 / $85.96	Professional		$85.96	$85.96	$85.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $90.21 / $171.58 / $246.56	Facility		$90.21	$171.58	$246.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.21 / $169.79 / $230.04	Professional		$90.21	$169.79	$230.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $92.59	Professional		$30.00	$75.00	$92.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $119.90 / $144.02 / $146.06	Facility		$119.90	$144.02	$146.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.68 / $90.77 / $172.95	Facility		$82.68	$90.77	$172.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.87 / $85.96 / $91.02	Professional		$77.87	$85.96	$91.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $100.98 / $100.98 / $111.08	Facility		$100.98	$100.98	$111.08
United Facility/Professional Professional Modifier Low / Median / High Price $136.47 / $136.47 / $163.76	Professional		$136.47	$136.47	$163.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $80.90 / $80.90	Professional		$80.90	$80.90	$80.90