Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.34 / $75.34 / $75.34	Facility		$75.34	$75.34	$75.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $74.65 / $75.34	Professional		$68.48	$74.65	$75.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $15.43 / $91.10 / $302.37	Facility		$15.43	$91.10	$302.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $68.48 / $335.66	Professional		$65.06	$68.48	$335.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.61 / $64.61 / $136.97	Facility		$64.61	$64.61	$136.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $83.99	Professional		$68.48	$68.48	$83.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $68.48 / $92.46	Facility		$68.48	$68.48	$92.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $92.46	Professional		$68.48	$68.48	$92.46
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 $67.31 / $68.48 / $142.13	Facility		$67.31	$68.48	$142.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.61 / $49.80 / $72.36	Facility		$14.61	$49.80	$72.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.36 / $74.30 / $125.86	Professional		$72.36	$74.30	$125.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $0.55 / $68.48 / $68.48	Facility		$0.55	$68.48	$68.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $68.48 / $68.48	Professional		$65.06	$68.48	$68.48
United Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $82.19	Professional		$68.48	$68.48	$82.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Professional		$68.48	$68.48	$68.48