Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.92 / $112.92 / $112.92	Facility		$112.92	$112.92	$112.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.55 / $103.50 / $123.03	Professional		$61.55	$103.50	$123.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $139.52 / $343.58 / $343.58	Facility		$139.52	$343.58	$343.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $28.88 / $176.13 / $744.53	Professional		$28.88	$176.13	$744.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.40 / $83.40 / $109.06	Professional		$83.40	$83.40	$109.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $252.48 / $252.48 / $252.48	Professional		$252.48	$252.48	$252.48
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 $33.63 / $47.09 / $163.47	Facility		$33.63	$47.09	$163.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.52 / $139.52 / $139.52	Facility		$139.52	$139.52	$139.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.79 / $232.26 / $297.52	Professional		$150.79	$232.26	$297.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $162.44 / $162.44 / $162.44	Facility		$162.44	$162.44	$162.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $82.96 / $142.30 / $205.59	Professional		$82.96	$142.30	$205.59
United Facility/Professional Professional Modifier Low / Median / High Price $132.44 / $200.08 / $304.39	Professional		$132.44	$200.08	$304.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.41 / $69.11 / $99.89	Professional		$30.41	$69.11	$99.89