Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.74 / $88.74 / $88.74	Facility		$88.74	$88.74	$88.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $88.74 / $105.23	Professional		$75.81	$88.74	$105.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $191.55 / $810.36 / $1,408.76	Facility		$191.55	$810.36	$1,408.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $112.73 / $201.71 / $808.05	Professional		$112.73	$201.71	$808.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.75 / $147.75 / $147.75	Professional		$147.75	$147.75	$147.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $350.50 / $953.68 / $1,766.17	Facility		$350.50	$953.68	$1,766.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $285.43 / $285.43 / $285.43	Professional		$285.43	$285.43	$285.43
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 $154.55 / $266.33 / $357.86	Facility		$154.55	$266.33	$357.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.69 / $118.69 / $128.41	Facility		$118.69	$118.69	$128.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.24 / $205.77 / $263.38	Professional		$135.24	$205.77	$263.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $796.30 / $1,042.49 / $1,994.17	Facility		$796.30	$1,042.49	$1,994.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.73 / $163.85 / $241.38	Professional		$112.73	$163.85	$241.38
United Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $101.70 / $240.34	Professional		$88.00	$101.70	$240.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.22 / $80.22 / $80.22	Professional		$80.22	$80.22	$80.22