Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.79 / $55.79 / $55.79	Facility		$55.79	$55.79	$55.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $52.24 / $55.79	Professional		$50.72	$52.24	$55.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.72 / $97.75 / $229.79	Facility		$50.72	$97.75	$229.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $47.42 / $50.72 / $229.79	Professional		$47.42	$50.72	$229.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.84 / $47.84 / $109.24	Facility		$47.84	$47.84	$109.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.71 / $50.71 / $62.20	Professional		$50.71	$50.71	$62.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.72 / $50.72 / $68.47	Facility		$50.72	$50.72	$68.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $50.72 / $68.47	Professional		$50.72	$50.72	$68.47
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 $43.45 / $50.71 / $94.25	Facility		$43.45	$50.71	$94.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.38 / $95.45 / $95.45	Facility		$61.38	$95.45	$95.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.46 / $61.38 / $100.66	Professional		$56.46	$61.38	$100.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $50.72 / $50.72 / $50.72	Facility		$50.72	$50.72	$50.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $50.72 / $50.72	Professional		$48.18	$50.72	$50.72
United Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $50.72 / $60.86	Professional		$50.72	$50.72	$60.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $50.72 / $52.05	Professional		$50.72	$50.72	$52.05