Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.15 / $63.15 / $63.15	Facility		$63.15	$63.15	$63.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.79 / $50.15 / $120.00	Professional		$42.79	$50.15	$120.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $80.77 / $227.07 / $571.58	Facility		$80.77	$227.07	$571.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $108.41 / $425.33	Professional		$57.00	$108.41	$425.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.93 / $94.51 / $152.16	Professional		$51.93	$94.51	$152.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $46.81 / $93.86 / $395.70	Facility		$46.81	$93.86	$395.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.47 / $72.67 / $124.95	Professional		$42.47	$72.67	$124.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $81.40 / $98.39 / $99.16	Facility		$81.40	$98.39	$99.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.06 / $62.06 / $67.64	Facility		$62.06	$62.06	$67.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.09 / $110.00 / $134.25	Professional		$69.09	$110.00	$134.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $287.05 / $442.67 / $846.77	Facility		$287.05	$442.67	$846.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.29 / $91.45 / $122.01	Professional		$63.29	$91.45	$122.01
United Facility/Professional Professional Modifier Low / Median / High Price $49.78 / $76.13 / $134.01	Professional		$49.78	$76.13	$134.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $57.00 / $57.00	Professional		$57.00	$57.00	$57.00