Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.77 / $278.32 / $18,711.00	Facility		$127.77	$278.32	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $115.58 / $278.32	Professional		$67.56	$115.58	$278.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $202.04 / $1,129.34 / $2,161.55	Facility		$202.04	$1,129.34	$2,161.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $100.90 / $277.80 / $1,090.64	Professional		$100.90	$277.80	$1,090.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.12 / $186.25 / $388.89	Professional		$91.12	$186.25	$388.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $102.50 / $183.76 / $381.25	Facility		$102.50	$183.76	$381.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.16 / $186.66 / $381.25	Professional		$104.16	$186.66	$381.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $200.24 / $357.19	Professional		$36.17	$200.24	$357.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.84 / $254.22 / $293.45	Facility		$120.84	$254.22	$293.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $200.17 / $200.17 / $202.04	Facility		$200.17	$200.17	$202.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.36 / $194.02 / $366.91	Professional		$99.36	$194.02	$366.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $732.75 / $1,129.34 / $2,161.55	Facility		$732.75	$1,129.34	$2,161.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.63 / $183.30 / $339.01	Professional		$95.63	$183.30	$339.01
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 $104.49 / $204.48 / $431.86	Professional		$104.49	$204.48	$431.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.39 / $71.39 / $159.79	Professional		$71.39	$71.39	$159.79