Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.13 / $111.13 / $6,102.74	Facility		$111.13	$111.13	$6,102.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $111.13 / $151.54	Professional		$101.03	$111.13	$151.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $65.51 / $118.75 / $547.60	Facility		$65.51	$118.75	$547.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $93.17 / $101.03 / $466.64	Professional		$93.17	$101.03	$466.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.31 / $95.31 / $210.92	Facility		$95.31	$95.31	$210.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $123.91	Professional		$101.03	$101.03	$123.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $76.52 / $112.79 / $290.69	Facility		$76.52	$112.79	$290.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.52 / $110.49 / $273.64	Professional		$76.52	$110.49	$273.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $75.00	Professional		$30.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $98.54 / $101.03 / $190.95	Facility		$98.54	$101.03	$190.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.65 / $93.10 / $170.22	Facility		$63.65	$93.10	$170.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.67 / $124.63 / $204.41	Professional		$114.67	$124.63	$204.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $101.03 / $120.78 / $300.74	Facility		$101.03	$120.78	$300.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.98 / $101.03 / $105.07	Professional		$95.98	$101.03	$105.07
United Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $121.24	Professional		$101.03	$101.03	$121.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $105.69	Professional		$101.03	$101.03	$105.69