Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.83 / $347.72 / $13,750.00	Facility		$54.83	$347.72	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $119.20 / $333.47	Professional		$28.10	$119.20	$333.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $76.06 / $786.75 / $1,605.58	Facility		$76.06	$786.75	$1,605.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $52.74 / $214.17 / $862.48	Professional		$52.74	$214.17	$862.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.39 / $714.97 / $870.49	Facility		$208.39	$714.97	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.04 / $115.92 / $341.34	Professional		$39.04	$115.92	$341.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.28 / $137.62 / $313.75	Facility		$38.28	$137.62	$313.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.28 / $128.03 / $306.12	Professional		$38.28	$128.03	$306.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.06 / $201.51 / $357.19	Professional		$37.06	$201.51	$357.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $60.30 / $222.90 / $247.02	Facility		$60.30	$222.90	$247.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.51 / $159.94 / $217.72	Facility		$72.51	$159.94	$217.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.43 / $100.07 / $293.20	Professional		$49.43	$100.07	$293.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $544.28 / $838.87 / $1,605.58	Facility		$544.28	$838.87	$1,605.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.93 / $114.41 / $288.68	Professional		$47.93	$114.41	$288.68
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $147.97 / $204.63 / $344.64	Professional		$147.97	$204.63	$344.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $93.58 / $129.51	Professional		$30.86	$93.58	$129.51