Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.85 / $61.11 / $100.83	Facility		$55.85	$61.11	$100.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.36 / $60.39 / $68.51	Professional		$43.36	$60.39	$68.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $83.07 / $125.66 / $286.08	Facility		$83.07	$125.66	$286.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $142.49 / $514.28	Professional		$77.62	$142.49	$514.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.67 / $88.66 / $101.44	Professional		$84.67	$88.66	$101.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.03 / $103.67 / $187.20	Facility		$38.03	$103.67	$187.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.95 / $181.95 / $181.95	Professional		$181.95	$181.95	$181.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.28 / $56.95 / $62.57	Facility		$46.28	$56.95	$62.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.54 / $81.54 / $81.80	Facility		$81.54	$81.54	$81.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.48 / $134.69 / $162.37	Professional		$92.48	$134.69	$162.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $81.63 / $108.13 / $204.42	Facility		$81.63	$108.13	$204.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $103.25 / $155.88	Professional		$73.20	$103.25	$155.88
United Facility/Professional Facility Modifier Low / Median / High Price $4.78 / $59.95 / $64.73	Facility		$4.78	$59.95	$64.73
United Facility/Professional Professional Modifier Low / Median / High Price $72.23 / $97.44 / $166.32	Professional		$72.23	$97.44	$166.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,804.27 / $3,804.27 / $3,804.27	Professional		$3,804.27	$3,804.27	$3,804.27