Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.78 / $67.44 / $128.62	Facility		$34.78	$67.44	$128.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.75 / $40.54 / $88.45	Professional		$26.75	$40.54	$88.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $119.57 / $1,129.34 / $2,161.55	Facility		$119.57	$1,129.34	$2,161.55
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $5.45 / $11.96 / $11.96	Facility	AS	$5.45	$11.96	$11.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $74.00 / $318.22	Professional		$28.00	$74.00	$318.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.97 / $46.48 / $107.75	Professional		$24.97	$46.48	$107.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $39.60 / $67.05 / $132.05	Facility		$39.60	$67.05	$132.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.72 / $67.05 / $128.55	Professional		$40.72	$67.05	$128.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.01 / $99.99 / $175.76	Professional		$18.01	$99.99	$175.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $52.93 / $85.76 / $102.51	Facility		$52.93	$85.76	$102.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.56 / $51.56 / $67.04	Facility		$51.56	$51.56	$67.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.40 / $67.45 / $120.58	Professional		$38.40	$67.45	$120.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $732.75 / $1,129.34 / $2,161.55	Facility		$732.75	$1,129.34	$2,161.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $27.26 / $49.62 / $82.87	Professional		$27.26	$49.62	$82.87
United Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $52.69 / $142.35	Professional		$45.85	$52.69	$142.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.62 / $27.62 / $57.61	Professional		$27.62	$27.62	$57.61