Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.27 / $139.08 / $145.21	Facility		$61.27	$139.08	$145.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.51 / $61.27 / $146.80	Professional		$46.51	$61.27	$146.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $94.71 / $508.15 / $508.15	Facility		$94.71	$508.15	$508.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $95.52 / $538.69	Professional		$78.00	$95.52	$538.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.13 / $44.13 / $80.26	Professional		$44.13	$44.13	$80.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $63.77 / $110.33 / $185.96	Facility		$63.77	$110.33	$185.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $110.34 / $195.29	Professional		$64.48	$110.34	$195.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $75.00 / $108.17	Professional		$60.00	$75.00	$108.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $85.85 / $105.63 / $108.17	Facility		$85.85	$105.63	$108.17
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $91.94 / $108.17 / $108.17	Professional		$91.94	$108.17	$108.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.79 / $94.71 / $175.13	Facility		$89.79	$94.71	$175.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.79 / $102.46 / $155.44	Professional		$89.79	$102.46	$155.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $85.92 / $91.94 / $118.99	Professional		$85.92	$91.94	$118.99
United Facility/Professional Professional Modifier Low / Median / High Price $42.40 / $45.94 / $87.51	Professional		$42.40	$45.94	$87.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.12 / $69.12 / $69.12	Professional		$69.12	$69.12	$69.12