Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $102.36 / $168.06	Facility		$84.67	$102.36	$168.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $102.36 / $141.49	Professional		$40.65	$102.36	$141.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $105.10 / $137.85 / $345.79	Facility		$105.10	$137.85	$345.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $106.02 / $183.16 / $675.38	Professional		$106.02	$183.16	$675.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.63 / $123.77 / $242.80	Professional		$44.63	$123.77	$242.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $42.44 / $74.00 / $204.94	Facility		$42.44	$74.00	$204.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.50 / $82.75 / $240.95	Professional		$43.50	$82.75	$240.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.09 / $100.77 / $181.95	Professional		$18.09	$100.77	$181.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $55.86 / $138.71 / $155.44	Facility		$55.86	$138.71	$155.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.10 / $105.10 / $106.02	Facility		$105.10	$105.10	$106.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.02 / $171.68 / $210.45	Professional		$106.02	$171.68	$210.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $105.93 / $140.18 / $193.39	Professional		$105.93	$140.18	$193.39
United Facility/Professional Facility Modifier Low / Median / High Price $73.75 / $73.75 / $73.75	Facility		$73.75	$73.75	$73.75
United Facility/Professional Professional Modifier Low / Median / High Price $49.01 / $92.58 / $224.97	Professional		$49.01	$92.58	$224.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.98 / $89.98 / $89.98	Professional		$89.98	$89.98	$89.98