Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.00 / $496.09 / $13,809.00	Facility		$205.00	$496.09	$13,809.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $180.61 / $451.15	Professional		$107.00	$180.61	$451.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,308.60 / $12,053.91	Facility		$55.00	$5,308.60	$12,053.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $176.61 / $366.43 / $1,400.56	Professional		$176.61	$366.43	$1,400.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.11 / $625.25 / $842.00	Facility		$182.11	$625.25	$842.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.01 / $273.86 / $533.65	Professional		$139.01	$273.86	$533.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $145.74 / $258.32 / $493.45	Facility		$145.74	$258.32	$493.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.02 / $245.66 / $424.64	Professional		$139.02	$245.66	$424.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.85 / $243.92 / $429.64	Professional		$40.85	$243.92	$429.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $218.42 / $330.98 / $379.89	Facility		$218.42	$330.98	$379.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.01 / $254.59 / $259.12	Facility		$141.01	$254.59	$259.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.72 / $290.75 / $489.70	Professional		$182.72	$290.75	$489.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,916.52 / $9,118.81 / $17,453.22	Facility		$5,916.52	$9,118.81	$17,453.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $182.82 / $298.70 / $430.64	Professional		$182.82	$298.70	$430.64
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,436.00 / $6,486.14	Facility		$650.00	$1,436.00	$6,486.14
United Facility/Professional Professional Modifier Low / Median / High Price $191.36 / $306.41 / $546.47	Professional		$191.36	$306.41	$546.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $121.65 / $154.87 / $210.83	Professional		$121.65	$154.87	$210.83