Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.83 / $105.44 / $222.12	Facility		$31.83	$105.44	$222.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.33 / $31.83 / $32.84	Professional		$21.33	$31.83	$32.84
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $54.18 / $139.88	Facility		$35.54	$54.18	$139.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $30.47 / $70.33 / $253.95	Professional		$30.47	$70.33	$253.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.22 / $71.98 / $87.43	Facility		$35.22	$71.98	$87.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.47 / $33.86 / $57.56	Facility		$30.47	$33.86	$57.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.47 / $33.86 / $84.65	Professional		$30.47	$33.86	$84.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $30.47 / $37.25 / $59.26	Facility		$30.47	$37.25	$59.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.86 / $59.25 / $104.97	Facility		$33.86	$59.25	$104.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.47 / $42.33 / $51.13	Professional		$30.47	$42.33	$51.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $54.18 / $93.12	Facility		$35.54	$54.18	$93.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $37.45 / $66.00 / $78.95	Professional		$37.45	$66.00	$78.95
United Facility/Professional Professional Modifier Low / Median / High Price $14.22 / $14.22 / $37.25	Professional		$14.22	$14.22	$37.25