Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.08 / $135.08 / $135.08	Facility		$135.08	$135.08	$135.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.72 / $113.85 / $135.08	Professional		$47.72	$113.85	$135.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $152.78 / $467.77 / $1,119.24	Facility		$152.78	$467.77	$1,119.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $135.37 / $230.82 / $888.53	Professional		$135.37	$230.82	$888.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.68 / $231.44 / $410.99	Professional		$121.68	$231.44	$410.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $53.55 / $89.92 / $245.65	Facility		$53.55	$89.92	$245.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.80 / $86.67 / $187.62	Professional		$52.80	$86.67	$187.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.21 / $41.91 / $63.12	Professional		$21.21	$41.91	$63.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.06 / $53.57 / $207.03	Facility		$42.06	$53.57	$207.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.72 / $132.72 / $141.21	Facility		$132.72	$132.72	$141.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.35 / $229.98 / $280.29	Professional		$154.35	$229.98	$280.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $548.89 / $846.46 / $1,619.17	Facility		$548.89	$846.46	$1,619.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.67 / $187.25 / $256.47	Professional		$125.67	$187.25	$256.47
United Facility/Professional Facility Modifier Low / Median / High Price $107.00 / $666.00 / $6,216.00	Facility		$107.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $99.78 / $136.54 / $263.75	Professional		$99.78	$136.54	$263.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.83 / $60.83 / $107.19	Professional		$60.83	$60.83	$107.19