Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.59 / $50.59 / $50.59	Facility		$50.59	$50.59	$50.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $48.48 / $57.17	Professional		$35.58	$48.48	$57.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $184.31 / $339.32 / $692.47	Facility		$184.31	$339.32	$692.47
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $91.47 / $377.10	Professional		$50.29	$91.47	$377.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.53 / $19.53 / $68.88	Professional		$15.53	$19.53	$68.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $115.16 / $115.16 / $547.23	Facility		$115.16	$115.16	$547.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.94 / $132.94 / $132.94	Professional		$132.94	$132.94	$132.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $43.23 / $61.44 / $87.77	Facility		$43.23	$61.44	$87.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.87 / $59.87 / $62.97	Facility		$59.87	$59.87	$62.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.88 / $99.04 / $122.79	Professional		$62.88	$99.04	$122.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $234.74 / $361.80 / $692.47	Facility		$234.74	$361.80	$692.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.52 / $76.76 / $105.99	Professional		$60.52	$76.76	$105.99
United Facility/Professional Professional Modifier Low / Median / High Price $51.69 / $83.62 / $137.50	Professional		$51.69	$83.62	$137.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $38.20 / $38.20	Professional		$38.20	$38.20	$38.20