Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.37 / $83.37 / $83.37	Facility		$83.37	$83.37	$83.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $83.37 / $90.67	Professional		$75.79	$83.37	$90.67
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $75.79 / $969.00 / $1,140.00	Facility		$75.79	$969.00	$1,140.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $75.79 / $1,311.00	Professional		$75.79	$75.79	$1,311.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.50 / $71.50 / $143.00	Facility		$71.50	$71.50	$143.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $75.79 / $92.95	Professional		$75.79	$75.79	$92.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $75.79 / $75.79 / $102.32	Facility		$75.79	$75.79	$102.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $75.79 / $102.32	Professional		$75.79	$75.79	$102.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $75.00 / $75.00	Professional		$50.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.79 / $83.18 / $253.52	Facility		$75.79	$83.18	$253.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.27 / $946.20 / $946.20	Facility		$180.27	$946.20	$946.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.57 / $146.47 / $230.97	Professional		$129.57	$146.47	$230.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $75.79 / $75.79 / $75.79	Facility		$75.79	$75.79	$75.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $75.79 / $75.79	Professional		$72.00	$75.79	$75.79
United Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $75.79 / $90.95	Professional		$75.79	$75.79	$90.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $75.79 / $119.43	Professional		$75.79	$75.79	$119.43