Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.30 / $88.17 / $121.12	Facility		$57.30	$88.17	$121.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.66 / $52.39 / $66.58	Professional		$43.66	$52.39	$66.58
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $78.81 / $95.88 / $230.12	Facility		$78.81	$95.88	$230.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $109.13 / $369.98	Professional		$67.73	$109.13	$369.98
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $46.44 / $69.51 / $89.69	Professional	25	$46.44	$69.51	$89.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.01 / $95.58 / $149.99	Professional		$63.01	$95.58	$149.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.24 / $66.06 / $121.08	Facility		$47.24	$66.06	$121.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.24 / $64.90 / $115.56	Professional		$47.24	$64.90	$115.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $98.46 / $160.01	Professional		$18.73	$98.46	$160.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $71.87 / $115.09 / $120.60	Facility		$71.87	$115.09	$120.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.81 / $78.81 / $88.47	Facility		$78.81	$78.81	$88.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.70 / $110.14 / $144.69	Professional		$74.70	$110.14	$144.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.62 / $92.11 / $136.53	Professional		$69.62	$92.11	$136.53
United Facility/Professional Professional Modifier Low / Median / High Price $76.56 / $99.19 / $165.71	Professional		$76.56	$99.19	$165.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.61 / $53.55 / $65.38	Professional		$49.61	$53.55	$65.38