Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.68 / $57.08 / $152.46	Facility		$35.68	$57.08	$152.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.68 / $51.43 / $80.63	Professional		$35.68	$51.43	$80.63
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $54.29 / $54.29 / $54.29	Professional	25	$54.29	$54.29	$54.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $81.99 / $102.49 / $216.24	Facility		$81.99	$102.49	$216.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $60.52 / $110.20 / $386.12	Professional		$60.52	$110.20	$386.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.95 / $55.95 / $55.95	Professional		$55.95	$55.95	$55.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.04 / $61.12 / $106.74	Facility		$40.04	$61.12	$106.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.04 / $60.38 / $102.33	Professional		$40.04	$60.38	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.44 / $99.31 / $173.59	Professional		$18.44	$99.31	$173.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.58 / $118.24 / $125.96	Facility		$75.58	$118.24	$125.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.99 / $81.99 / $85.92	Facility		$81.99	$81.99	$85.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.88 / $102.91 / $147.84	Professional		$62.88	$102.91	$147.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.52 / $85.21 / $136.69	Professional		$60.52	$85.21	$136.69
United Facility/Professional Professional Modifier Low / Median / High Price $77.44 / $102.88 / $173.84	Professional		$77.44	$102.88	$173.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.90 / $51.90 / $61.93	Professional		$51.90	$51.90	$61.93