Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.81 / $64.81 / $64.81	Facility		$64.81	$64.81	$64.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.69 / $64.81 / $114.52	Professional		$31.69	$64.81	$114.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $81.63 / $108.15 / $208.63	Facility		$81.63	$108.15	$208.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $92.89 / $163.41 / $638.63	Professional		$92.89	$163.41	$638.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.03 / $135.63 / $340.01	Facility		$38.03	$135.63	$340.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $225.54 / $225.54 / $225.54	Professional		$225.54	$225.54	$225.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $50.00	Professional		$45.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.00 / $136.91 / $148.74	Facility		$91.00	$136.91	$148.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.73 / $79.73 / $101.45	Facility		$79.73	$79.73	$101.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.45 / $157.19 / $201.38	Professional		$101.45	$157.19	$201.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $81.63 / $108.15 / $204.42	Facility		$81.63	$108.15	$204.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $90.09 / $142.44 / $196.58	Professional		$90.09	$142.44	$196.58
United Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $100.49 / $187.82	Professional		$64.48	$100.49	$187.82