Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.69 / $100.69 / $100.69	Facility		$100.69	$100.69	$100.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $94.29 / $100.69	Professional		$91.54	$94.29	$100.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $91.54 / $136.00 / $304.81	Facility		$91.54	$136.00	$304.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $82.39 / $91.54 / $304.81	Professional		$82.39	$91.54	$304.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.36 / $86.36 / $137.12	Facility		$86.36	$86.36	$137.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $112.26	Professional		$91.54	$91.54	$112.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.54 / $91.54 / $123.58	Facility		$91.54	$91.54	$123.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $114.42	Professional		$91.54	$91.54	$114.42
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 $62.86 / $91.54 / $173.01	Facility		$62.86	$91.54	$173.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.22 / $132.80 / $132.80	Facility		$104.22	$132.80	$132.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.91 / $84.68 / $133.54	Professional		$74.91	$84.68	$133.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $91.54 / $91.54 / $91.54	Facility		$91.54	$91.54	$91.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $86.96 / $91.54 / $91.54	Professional		$86.96	$91.54	$91.54
United Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $109.85	Professional		$91.54	$91.54	$109.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.04 / $91.54 / $91.54	Professional		$69.04	$91.54	$91.54