Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.38 / $104.69 / $981.56	Facility		$22.38	$104.69	$981.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $21.17 / $106.13	Professional		$20.35	$21.17	$106.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.66 / $86.66 / $628.59	Facility		$50.66	$86.66	$628.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $23.40 / $573.77	Professional		$20.35	$23.40	$573.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.20 / $20.35 / $112.40	Facility		$19.20	$20.35	$112.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $20.35 / $27.63	Professional		$20.35	$20.35	$27.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $20.35 / $54.29 / $273.32	Facility		$20.35	$54.29	$273.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $52.46 / $265.02	Professional		$20.35	$52.46	$265.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.38 / $28.16 / $42.40	Professional		$22.38	$28.16	$42.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $20.35 / $28.27 / $84.81	Facility		$20.35	$28.27	$84.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.85 / $104.52 / $177.37	Facility		$53.85	$104.52	$177.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.59 / $62.52 / $106.68	Professional		$51.59	$62.52	$106.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $79.02 / $120.59	Facility		$23.99	$79.02	$120.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $22.39 / $24.42	Professional		$20.35	$22.39	$24.42
United Facility/Professional Facility Modifier Low / Median / High Price $60.16 / $60.16 / $60.16	Facility		$60.16	$60.16	$60.16
United Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $20.35 / $24.42	Professional		$20.35	$20.35	$24.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $20.35 / $46.35	Professional		$20.35	$20.35	$46.35