Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.66 / $117.66 / $117.66	Facility		$117.66	$117.66	$117.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $110.18 / $117.66	Professional		$106.97	$110.18	$117.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $93.00 / $120.66 / $167.68	Facility		$93.00	$120.66	$167.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $57.33 / $106.97 / $504.23	Professional		$57.33	$106.97	$504.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.73 / $100.91 / $106.97	Facility		$75.73	$100.91	$106.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $131.19	Professional		$106.97	$106.97	$131.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $106.97 / $106.97 / $144.41	Facility		$106.97	$106.97	$144.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $133.71	Professional		$106.97	$106.97	$133.71
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 $42.74 / $106.96 / $194.25	Facility		$42.74	$106.96	$194.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.33 / $93.00 / $93.00	Facility		$57.33	$93.00	$93.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $47.65 / $73.45	Professional		$41.20	$47.65	$73.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $106.97 / $106.97 / $106.97	Facility		$106.97	$106.97	$106.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $101.62 / $106.97 / $106.97	Professional		$101.62	$106.97	$106.97
United Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $128.36	Professional		$106.97	$106.97	$128.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $106.97 / $106.97	Professional		$37.97	$106.97	$106.97