Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.04 / $88.04 / $88.04	Facility		$88.04	$88.04	$88.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $87.24 / $88.04	Professional		$80.04	$87.24	$88.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $883.50 / $2,756.52	Facility		$80.04	$883.50	$2,756.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $2,756.52	Professional		$80.04	$80.04	$2,756.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $75.51 / $160.08	Facility		$75.51	$75.51	$160.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $98.16	Professional		$80.04	$80.04	$98.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $108.05	Facility		$80.04	$80.04	$108.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $108.05	Professional		$80.04	$80.04	$108.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $83.06 / $624.34	Facility		$80.04	$83.06	$624.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $488.87 / $488.87 / $659.68	Facility		$488.87	$488.87	$659.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $612.55 / $677.35 / $1,147.36	Professional		$612.55	$677.35	$1,147.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Facility		$80.04	$80.04	$80.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $76.04 / $80.04 / $80.04	Professional		$76.04	$80.04	$80.04
United Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $96.05	Professional		$80.04	$80.04	$96.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $624.34	Professional		$80.04	$80.04	$624.34