Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.85 / $162.85 / $162.85	Facility		$162.85	$162.85	$162.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.85 / $162.85 / $243.55	Professional		$90.85	$162.85	$243.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $202.94 / $270.30 / $714.54	Facility		$202.94	$270.30	$714.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $208.77 / $355.40 / $1,357.73	Professional		$208.77	$355.40	$1,357.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $479.49 / $479.49 / $479.49	Professional		$479.49	$479.49	$479.49
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 $207.51 / $300.16 / $316.24	Facility		$207.51	$300.16	$316.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $202.94 / $202.94 / $215.70	Facility		$202.94	$202.94	$215.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.34 / $340.88 / $428.15	Professional		$216.34	$340.88	$428.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $206.98 / $302.83 / $417.96	Professional		$206.98	$302.83	$417.96
United Facility/Professional Professional Modifier Low / Median / High Price $197.12 / $259.85 / $436.80	Professional		$197.12	$259.85	$436.80