Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.30 / $138.74 / $161.18	Facility		$76.30	$138.74	$161.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $71.45 / $93.76	Professional		$69.37	$71.45	$93.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $40.31 / $93.95 / $457.60	Facility		$40.31	$93.95	$457.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $76.31 / $317.82	Professional		$69.37	$76.31	$317.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.71 / $69.37 / $147.82	Facility		$63.71	$69.37	$147.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $69.37 / $82.82	Professional		$69.37	$69.37	$82.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $68.88 / $69.37 / $161.52	Facility		$68.88	$69.37	$161.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $69.37 / $140.63	Professional		$69.37	$69.37	$140.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $77.48 / $93.64	Professional		$69.37	$77.48	$93.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.08 / $77.48 / $182.99	Facility		$68.08	$77.48	$182.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.28 / $72.02 / $112.86	Facility		$36.28	$72.02	$112.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.09 / $84.88 / $139.19	Professional		$78.09	$84.88	$139.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $38.83 / $76.31 / $144.47	Facility		$38.83	$76.31	$144.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $76.31 / $83.24	Professional		$69.37	$76.31	$83.24
United Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $69.37 / $83.24	Professional		$69.37	$69.37	$83.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.98 / $71.98 / $71.98	Professional		$71.98	$71.98	$71.98