Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.70 / $143.10 / $148.82	Facility		$78.70	$143.10	$148.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $77.98 / $78.70	Professional		$71.55	$77.98	$78.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $17.34 / $93.76 / $390.68	Facility		$17.34	$93.76	$390.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $71.55 / $468.81	Professional		$67.84	$71.55	$468.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.50 / $67.50 / $143.10	Facility		$67.50	$67.50	$143.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $87.75	Professional		$71.55	$71.55	$87.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $18.86 / $47.16 / $71.55	Facility		$18.86	$47.16	$71.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.84 / $47.16 / $71.55	Professional		$19.84	$47.16	$71.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $75.00	Professional		$30.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $37.60 / $71.55 / $148.50	Facility		$37.60	$71.55	$148.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.04 / $86.47 / $88.55	Facility		$14.04	$86.47	$88.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.22 / $88.55 / $93.76	Professional		$80.22	$88.55	$93.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $15.76 / $71.55 / $71.55	Facility		$15.76	$71.55	$71.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.97 / $71.55 / $71.55	Professional		$67.97	$71.55	$71.55
United Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $85.86	Professional		$71.55	$71.55	$85.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $86.81	Professional		$71.55	$71.55	$86.81