Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.86 / $77.86 / $83.26	Facility		$77.86	$77.86	$83.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.85 / $62.95 / $84.75	Professional		$48.85	$62.95	$84.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $110.39 / $293.80 / $293.80	Facility		$110.39	$293.80	$293.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $82.24 / $139.02 / $492.60	Professional		$82.24	$139.02	$492.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.95 / $55.95 / $64.77	Professional		$55.95	$55.95	$64.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.57 / $107.25 / $154.63	Facility		$57.57	$107.25	$154.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.94 / $100.28 / $161.21	Professional		$56.94	$100.28	$161.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.35 / $108.07 / $185.50	Professional		$18.35	$108.07	$185.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $82.66 / $123.69 / $126.63	Facility		$82.66	$123.69	$126.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.07 / $86.07 / $86.07	Facility		$86.07	$86.07	$86.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.37 / $137.85 / $171.21	Professional		$86.37	$137.85	$171.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $82.24 / $116.14 / $156.04	Professional		$82.24	$116.14	$156.04
United Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $105.46 / $181.52	Professional		$67.31	$105.46	$181.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.90 / $51.90 / $66.66	Professional		$51.90	$51.90	$66.66