Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.87 / $156.25 / $689.09	Facility		$103.87	$156.25	$689.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.48 / $90.90 / $180.64	Professional		$72.48	$90.90	$180.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $101.93 / $147.84 / $318.56	Facility		$101.93	$147.84	$318.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $103.95 / $180.94 / $636.45	Professional		$103.95	$180.94	$636.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.40 / $142.47 / $226.39	Professional		$78.40	$142.47	$226.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.27 / $130.80 / $203.78	Facility		$72.27	$130.80	$203.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.40 / $136.97 / $203.96	Professional		$74.40	$136.97	$203.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.41 / $109.44 / $185.62	Professional		$18.41	$109.44	$185.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $106.53 / $135.99 / $149.46	Facility		$106.53	$135.99	$149.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $99.63 / $99.63 / $101.93	Facility		$99.63	$99.63	$101.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.38 / $166.50 / $206.71	Professional		$106.38	$166.50	$206.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $101.45 / $135.54 / $257.51	Facility		$101.45	$135.54	$257.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $103.95 / $143.99 / $188.79	Professional		$103.95	$143.99	$188.79
United Facility/Professional Professional Modifier Low / Median / High Price $78.25 / $119.89 / $214.08	Professional		$78.25	$119.89	$214.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.15 / $80.23 / $80.23	Professional		$57.15	$80.23	$80.23