Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.18 / $203.33 / $13,750.00	Facility		$52.18	$203.33	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.06 / $64.06 / $160.52	Professional		$32.06	$64.06	$160.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $78.48 / $554.76 / $1,107.58	Facility		$78.48	$554.76	$1,107.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $43.48 / $158.57 / $673.04	Professional		$43.48	$158.57	$673.04
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $85.48 / $86.72 / $256.61	Professional	50	$85.48	$86.72	$256.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.27 / $99.27 / $150.93	Facility		$99.27	$99.27	$150.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.18 / $83.03 / $237.73	Professional		$37.18	$83.03	$237.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $42.07 / $92.50 / $183.40	Facility		$42.07	$92.50	$183.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.55 / $91.87 / $186.51	Professional		$44.55	$91.87	$186.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $150.45 / $267.18	Professional		$26.61	$150.45	$267.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $68.29 / $121.18 / $175.42	Facility		$68.29	$121.18	$175.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.84 / $122.76 / $123.85	Facility		$39.84	$122.76	$123.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $110.46 / $224.21	Professional		$40.65	$110.46	$224.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $367.90 / $567.35 / $1,085.27	Facility		$367.90	$567.35	$1,085.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $92.30 / $206.45	Professional		$38.81	$92.30	$206.45
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $588.00 / $5,793.00	Facility		$140.00	$588.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $88.80 / $118.18 / $259.73	Professional		$88.80	$118.18	$259.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $28.95 / $100.77	Professional		$28.95	$28.95	$100.77