Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.77 / $77.77 / $77.77	Facility		$77.77	$77.77	$77.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $71.40 / $77.77	Professional		$70.70	$71.40	$77.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $70.70 / $255.00 / $344.25	Facility		$70.70	$255.00	$344.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $73.53 / $459.00	Professional		$70.70	$73.53	$459.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.69 / $66.69 / $147.08	Facility		$66.69	$66.69	$147.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $70.70 / $86.70	Professional		$70.70	$70.70	$86.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $70.70 / $70.70 / $95.44	Facility		$70.70	$70.70	$95.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $70.70 / $95.44	Professional		$70.70	$70.70	$95.44
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 $70.70 / $71.04 / $147.43	Facility		$70.70	$71.04	$147.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $249.00 / $249.00	Facility		$109.65	$249.00	$249.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $89.09 / $140.49	Professional		$78.81	$89.09	$140.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $70.70 / $70.70 / $70.70	Facility		$70.70	$70.70	$70.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.17 / $70.70 / $70.70	Professional		$67.17	$70.70	$70.70
United Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $70.70 / $84.84	Professional		$70.70	$70.70	$84.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $70.70 / $72.64	Professional		$70.70	$70.70	$72.64