Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.31 / $127.56 / $168.89	Facility		$82.31	$127.56	$168.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $74.84 / $107.93	Professional		$62.75	$74.84	$107.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $109.17 / $139.30 / $337.57	Facility		$109.17	$139.30	$337.57
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $95.06 / $152.40 / $462.92	Professional		$95.06	$152.40	$462.92
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $68.13 / $87.92 / $123.20	Professional	25	$68.13	$87.92	$123.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.42 / $138.85 / $207.53	Professional		$90.42	$138.85	$207.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $67.20 / $91.67 / $172.69	Facility		$67.20	$91.67	$172.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.20 / $90.87 / $164.38	Professional		$67.20	$90.87	$164.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $98.49 / $160.76	Professional		$18.73	$98.49	$160.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.70 / $157.43 / $166.16	Facility		$99.70	$157.43	$166.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.17 / $109.17 / $121.89	Facility		$109.17	$109.17	$121.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.62 / $156.49 / $207.75	Professional		$108.62	$156.49	$207.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $99.84 / $129.60 / $191.39	Professional		$99.84	$129.60	$191.39
United Facility/Professional Professional Modifier Low / Median / High Price $105.31 / $137.38 / $231.37	Professional		$105.31	$137.38	$231.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.02 / $78.28 / $88.93	Professional		$69.02	$78.28	$88.93