Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.47 / $72.47 / $72.47	Facility		$72.47	$72.47	$72.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $72.31 / $72.47	Professional		$65.88	$72.31	$72.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $178.50 / $360.00	Facility		$65.88	$178.50	$360.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $62.59 / $65.88 / $3,978.60	Professional		$62.59	$65.88	$3,978.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.15 / $62.15 / $129.50	Facility		$62.15	$62.15	$129.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $80.80	Professional		$65.88	$65.88	$80.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $65.88 / $88.94	Facility		$65.88	$65.88	$88.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $88.94	Professional		$65.88	$65.88	$88.94
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 $65.88 / $66.34 / $124.51	Facility		$65.88	$66.34	$124.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $96.67 / $149.40 / $149.40	Facility		$96.67	$149.40	$149.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $80.36 / $123.86	Professional		$69.48	$80.36	$123.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $65.88 / $65.88	Facility		$65.88	$65.88	$65.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $62.59 / $65.88 / $65.88	Professional		$62.59	$65.88	$65.88
United Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $79.06	Professional		$65.88	$65.88	$79.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $65.88 / $65.88	Professional		$64.05	$65.88	$65.88