Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.16 / $67.20 / $154.56	Professional		$67.16	$67.20	$154.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $124.74 / $632.74 / $632.74	Facility		$124.74	$632.74	$632.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $14.34 / $107.57 / $159.88	Professional		$14.34	$107.57	$159.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.16 / $88.16 / $88.16	Facility		$88.16	$88.16	$88.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.94 / $88.16 / $115.71	Professional		$74.94	$88.16	$115.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $128.49 / $128.49 / $128.49	Facility		$128.49	$128.49	$128.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.49 / $128.49 / $128.49	Professional		$128.49	$128.49	$128.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.59 / $109.32 / $145.75	Professional		$14.59	$109.32	$145.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.49 / $134.38 / $159.49	Facility		$128.49	$134.38	$159.49
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $125.63 / $134.38 / $152.28	Professional		$125.63	$134.38	$152.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $143.44 / $174.64 / $218.30	Facility		$143.44	$174.64	$218.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.60 / $106.03 / $143.44	Professional		$10.60	$106.03	$143.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $124.74 / $124.74 / $124.74	Facility		$124.74	$124.74	$124.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $10.69 / $10.69 / $13.02	Professional		$10.69	$10.69	$13.02
United Facility/Professional Professional Modifier Low / Median / High Price $65.86 / $70.31 / $119.89	Professional		$65.86	$70.31	$119.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.71 / $112.71 / $112.71	Professional		$112.71	$112.71	$112.71