Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.70 / $83.70 / $83.70	Facility		$83.70	$83.70	$83.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $83.70 / $86.36	Professional		$76.09	$83.70	$86.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $76.09 / $285.18 / $671.00	Facility		$76.09	$285.18	$671.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $1,342.00	Professional		$76.09	$76.09	$1,342.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.78 / $71.78 / $172.70	Facility		$71.78	$71.78	$172.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $93.32	Professional		$76.09	$76.09	$93.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $76.09 / $76.09 / $102.72	Facility		$76.09	$76.09	$102.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $102.72	Professional		$76.09	$76.09	$102.72
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 $76.09 / $79.23 / $158.62	Facility		$76.09	$79.23	$158.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.35 / $278.45 / $278.45	Facility		$128.35	$278.45	$278.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.25 / $104.29 / $164.45	Professional		$92.25	$104.29	$164.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $76.09 / $76.09 / $76.09	Facility		$76.09	$76.09	$76.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.29 / $76.09 / $76.09	Professional		$72.29	$76.09	$76.09
United Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $91.31	Professional		$76.09	$76.09	$91.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $85.03	Professional		$76.09	$76.09	$85.03