Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.72 / $133.29 / $139.16	Facility		$58.72	$133.29	$139.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.25 / $58.72 / $140.68	Professional		$46.25	$58.72	$140.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $90.76 / $456.25 / $456.25	Facility		$90.76	$456.25	$456.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $68.03 / $90.76 / $535.65	Professional		$68.03	$90.76	$535.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.55 / $45.55 / $86.24	Professional		$45.55	$45.55	$86.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $66.34 / $111.50 / $191.48	Facility		$66.34	$111.50	$191.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $113.52 / $203.72	Professional		$66.34	$113.52	$203.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $75.00 / $103.66	Professional		$60.00	$75.00	$103.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $82.29 / $101.23 / $107.56	Facility		$82.29	$101.23	$107.56
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $93.29 / $103.66 / $107.56	Professional		$93.29	$103.66	$107.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.05 / $90.76 / $167.84	Facility		$86.05	$90.76	$167.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.05 / $98.19 / $148.97	Professional		$86.05	$98.19	$148.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $82.35 / $88.11 / $114.03	Professional		$82.35	$88.11	$114.03
United Facility/Professional Professional Modifier Low / Median / High Price $45.05 / $47.42 / $90.33	Professional		$45.05	$47.42	$90.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.44 / $53.44 / $53.44	Professional		$53.44	$53.44	$53.44