Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.31 / $107.39 / $112.13	Facility		$47.31	$107.39	$112.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.40 / $47.31 / $86.09	Professional		$38.40	$47.31	$86.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $138.80 / $382.31	Facility		$85.00	$138.80	$382.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $397.13 / $628.79	Professional		$85.00	$397.13	$628.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.49 / $43.49 / $43.49	Professional		$43.49	$43.49	$43.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.60 / $106.31 / $166.78	Facility		$50.60	$106.31	$166.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.84 / $106.31 / $166.78	Professional		$50.84	$106.31	$166.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $60.00	Professional		$30.00	$60.00	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $131.41 / $144.72	Facility		$67.61	$131.41	$144.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Facility		$85.00	$85.00	$85.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $85.00 / $85.00	Professional		$83.18	$85.00	$85.00
United Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $42.49 / $68.91	Professional		$34.36	$42.49	$68.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.39 / $51.39 / $60.20	Professional		$51.39	$51.39	$60.20