Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.53 / $5,128.00 / $22,024.00	Facility		$79.53	$5,128.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.90 / $79.53 / $90.21	Professional		$69.90	$79.53	$90.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $102.83 / $123.97 / $343.65	Facility		$102.83	$123.97	$343.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $104.87 / $178.02 / $662.70	Professional		$104.87	$178.02	$662.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $232.27 / $232.27 / $232.27	Professional		$232.27	$232.27	$232.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Professional		$50.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.66 / $145.65 / $152.09	Facility		$99.66	$145.65	$152.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.83 / $102.83 / $103.74	Facility		$102.83	$102.83	$103.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.39 / $165.03 / $205.91	Professional		$113.39	$165.03	$205.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.87 / $144.62 / $198.88	Professional		$104.87	$144.62	$198.88
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $95.34 / $131.65 / $224.32	Professional		$95.34	$131.65	$224.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $246.80 / $246.80 / $246.80	Professional		$246.80	$246.80	$246.80