Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.66 / $68.66 / $68.66	Facility		$68.66	$68.66	$68.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.41 / $65.19 / $68.66	Professional		$62.41	$65.19	$68.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $62.41 / $149.88 / $286.27	Facility		$62.41	$149.88	$286.27
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $62.41 / $62.41 / $371.52	Professional		$62.41	$62.41	$371.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $126.60	Facility		$58.88	$58.88	$126.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.41 / $62.41 / $76.55	Professional		$62.41	$62.41	$76.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $62.41 / $62.41 / $84.25	Facility		$62.41	$62.41	$84.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.41 / $62.41 / $84.25	Professional		$62.41	$62.41	$84.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $59.81 / $62.41 / $129.54	Facility		$59.81	$62.41	$129.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.22 / $80.92 / $80.92	Facility		$70.22	$80.92	$80.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $70.22 / $109.42	Professional		$64.59	$70.22	$109.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $54.22 / $62.41 / $62.41	Facility		$54.22	$62.41	$62.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $59.29 / $62.41 / $62.41	Professional		$59.29	$62.41	$62.41
United Facility/Professional Professional Modifier Low / Median / High Price $62.41 / $62.41 / $71.45	Professional		$62.41	$62.41	$71.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $59.54 / $62.41 / $62.41	Professional		$59.54	$62.41	$62.41