Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.65 / $167.73 / $257.79	Facility		$95.65	$167.73	$257.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.20 / $95.65 / $182.33	Professional		$34.20	$95.65	$182.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $108.27 / $126.64 / $361.81	Facility		$108.27	$126.64	$361.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $110.42 / $187.31 / $898.00	Professional		$110.42	$187.31	$898.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.70 / $171.24 / $259.70	Professional		$84.70	$171.24	$259.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $59.94 / $117.30 / $196.91	Facility		$59.94	$117.30	$196.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.24 / $122.65 / $199.96	Professional		$63.24	$122.65	$199.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.30 / $71.32 / $225.84	Professional		$10.30	$71.32	$225.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $62.31 / $136.01 / $162.13	Facility		$62.31	$136.01	$162.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $26.79 / $38.19	Professional		$25.65	$26.79	$38.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.27 / $108.27 / $110.59	Facility		$108.27	$108.27	$110.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.84 / $184.45 / $226.83	Professional		$113.84	$184.45	$226.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $66.98 / $66.98 / $66.98	Facility		$66.98	$66.98	$66.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $110.42 / $159.09 / $214.29	Professional		$110.42	$159.09	$214.29
United Facility/Professional Professional Modifier Low / Median / High Price $70.53 / $84.91 / $219.72	Professional		$70.53	$84.91	$219.72