Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.06 / $95.48 / $99.68	Facility		$42.06	$95.48	$99.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $42.06 / $100.07	Professional		$30.97	$42.06	$100.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.80 / $147.60 / $345.06	Facility		$100.80	$147.60	$345.06
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $61.20 / $64.56 / $648.41	Professional		$61.20	$64.56	$648.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $30.08 / $30.08	Professional		$30.08	$30.08	$30.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $108.67 / $180.57	Facility		$60.26	$108.67	$180.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $108.67 / $180.57	Professional		$71.00	$108.67	$180.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $64.80 / $73.73	Professional		$30.00	$64.80	$73.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $73.73 / $81.09	Facility		$72.00	$73.73	$81.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $58.56 / $58.56 / $58.56	Professional		$58.56	$58.56	$58.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.56 / $129.12 / $191.52	Facility		$64.56	$129.12	$191.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.20 / $72.00 / $82.80	Professional		$61.20	$72.00	$82.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $59.54 / $62.67 / $73.73	Professional		$59.54	$62.67	$73.73
United Facility/Professional Professional Modifier Low / Median / High Price $31.27 / $36.79 / $59.65	Professional		$31.27	$36.79	$59.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.67 / $62.67 / $73.73	Professional		$62.67	$62.67	$73.73